88例慢性肾脏病肾活检患者病理类型与中医证型转归关系的研究

目的:分析88例慢性肾脏病患者肾活检的病理分型与中医证型,旨在找出病理分型与中医证型及转归的关系。研究方法:回顾性研究我院肾病科2011年9月-2012年4月具有完整临床资料的肾活检患者病例,收集其病理类型、中医辨证资料,进行分析总结。结果:FSGS与MCG在15^年龄段分别占64.3%、75.0%,MN与MsPGN在36年龄段分别占64.3%、75.0%,MN与MsPGN在36^年龄段分别占78.6%、75.0%。IgAN、FSGS、MN、GML、MCG、MsPGN分别占39.8%、15.9%、15.9%、10.2%、9.1%、9.1%。脾肾气虚在所有中医证型的所占比例最多。FSGS、MN、GML中脾肾气虚所占比例最多,IgAN以脾肾气虚与肺肾气虚所占人数最多,MCG以脾肾气虚与气阴两虚所占比例最高,MsPGN以脾肾气虚与肝肾阴虚所占最多,血瘀、湿热证在各病理分型中均占较多比例。结论:FSGS与MCG在15年龄段分别占78.6%、75.0%。IgAN、FSGS、MN、GML、MCG、MsPGN分别占39.8%、15.9%、15.9%、10.2%、9.1%、9.1%。脾肾气虚在所有中医证型的所占比例最多。FSGS、MN、GML中脾肾气虚所占比例最多,IgAN以脾肾气虚与肺肾气虚所占人数最多,MCG以脾肾气虚与气阴两虚所占比例最高,MsPGN以脾肾气虚与肝肾阴虚所占最多,血瘀、湿热证在各病理分型中均占较多比例。结论:FSGS与MCG在15^年龄段多见,MN与MsPGN在36年龄段多见,MN与MsPGN在36^年龄段多见。IgAN所占比例最高,其次为FSGS、MN、GML、MCG、MsPGN。中医证型中脾肾气虚为目前临床上慢性肾脏病主要中医证型,随治疗时间延长,疾病后期气阴两虚证逐渐增多,血瘀证、湿热证常常伴随疾病始终。FSGS中医证型以脾肾气虚多见,易兼血瘀与湿热;IgAN中医证型以脾肾气虚与肺肾气虚居多,常伴有血瘀湿热;MN中医证型以脾肾气虚证居多;MCG脾肾气虚与气阴两虚较多;MsPGN患者脾肾气虚与肝肾阴虚占多数;GML证型以脾肾气虚为主,后四者在疾病进展中也出现明显的血瘀与湿热证。

Study on Relationship between 88 Cases of CKD Patients Pathology of Renal Biopsy and TCM Syndrome Types

Objective：To analyze the renal biopsy pathological typing and TCM syndrome types of 88 cases of chronic kidney disease patients to find out the relationship between pathological type and TCM syndrome type. Methods：A retrospective analysis of the clinical data of biopsy cases in our hospital during 2011 September -2012 April in department of nephropathy was carried out to collect the pathological type and TCM data and to make the summary. Results ：FSGS and MCG in 15 age group accounted for 64.3 % ,75 %. MN and MsPGN in 36 - age group accounted for 78.6% ,75%. IgAN, FSGS, MN, GML, MCG and MsPGN were 39.8% , 15.9% , 15.9% , 10.2% ,9.1% ,9.1%. Spleen and kidney qi deficiency in all TCM syndrome types had the largest pro- portion. Spleen and kidney qi deficiency accounted for the largest proportion of FSGS, MN, GML. IgAN in spleen and kidney Qi deficiency and Qi deficiency of lung and kidney accounted for the largest number. MCG in spleen and kidney Qi deficiency and Qi and yin deficiency accounted for the highest proportion. MsPGN with spleen and kidney Qi deficiency and yin deficiency of liver and kidney accounted for the largest number. Damp - heat syndrome and blood stasis accounted for more proportion in the patholo- gy typing. Conclusion：FSGS and MCG ages of 15 are more common. MN and MsPGN are common to ages of 36. The IgAN propor- tion was the highest, followed by of FSGS, Mn GML, MCG and MsPGN. Spleen and kidney Qi deficiency TCM syndrome is the main syndrome in chronic kidney disease. With the duration of treatment, Qi and yin deficiency gradually increased, blood stasis and damp - heat syndromes are often accompanied by infections. The spleen and kidney qi deficiency syndrome is more commonfor FSGS TCM syndromes, easily complicated with blood stasis and damp heat. IgAN TCM syndromes are mostly spleen and kidney Qi deficiency and lung and kidney Qi deficiency, often accompanied by blood stasis and damp heat. MN TCM syndromes are most- ly the spleen and kidney Qi deficiency syndrome and the spleen and kidney Qi deficiency and Qi and yin deficiency syndromes are more common for McG. For MsPGN, the spleen and kidney qi deficiency and liver and kidney yin deficiency are common. The GML main syndrome is spleen and kidney qi deficiency. The latter four show obvious blood stasis and damp - heat in the progres- sion of the disease.