IgA肾病气阴两虚证微观辨证研究

目的：探讨IgA肾病患者气阴两虚证与肾组织病理指标之间的相关性，为IgA肾病气阴两虚证的微观辨证提供依据，并对其他证型的深入研究提供借鉴。方法：对161例确诊为IgA肾病患者进行分组，其中气阴两虚证86例，非气阴两虚证75例，观察两组肾组织病理指标的变化。结果：86例气阴两虚证患者的病理分级多见Lee分型Ⅱ～Ⅳ级；气阴两虚证组肾小球系膜区免疫复合物沉积数目及程度均弱于非气阴两虚证组（P〈0.05）；气阴两虚证组患者的肾小球指数、系膜细胞增生、系膜基质增生、肾小管萎缩积分显著高于非气阴两虚证组（P〈0．05）；间质浸润、间质纤维化积分显著低于非气阴两虚讧组（P〈0．05）。结论：肾组织的病理分级、肾小球系膜区免疫复合物沉积数目及程度、肾小球指数、系膜细胞增生、系膜基质增生、肾小管萎缩、间质浸润、间质纤维化积分可作为IgA肾病气阴两虚证的微观辨证参考依据。

Study on the Micro Syndrome Differentiation of Deficiency of Both Qi and Yin Syndrome in Patients with IgA Nephropathy

Objective：To explore the indexes of the micro syndrome differentiation in IgA nephropathy （IgAN） patients with Deficiency of both vital Qi and Yin syndrome, Methods：To analyze the pathological data of 161 IgAN patients, among which 86 cases with Deficiency of both vital Qi and Yin syndrome, Results： In the 86 IgAN patients with Deficiency of both vital Qi and Yin syndrome （DQY）, Ⅱ - Ⅳ were mostly seen; the DQY was related to the deposition of immuncomplex in the mesangial region, and scores of glomerular inde, intercapillary cells accrementition, intercapillary base accrementition and tubular atrophy significantly higher while those of interstitial inflammatory cell infiltration and interstitial fibrosis significantly lower, but vascular index, glomemlar sclerosis index and crescent index has no significant contrast. Conclusion：Some pathological indexes would be the reference material of the diagnosis of micro syndrome differentiation on Deficiency of both vital Qi and Yin syndrome of IgAN.