肾失气化与肾小管病理损伤相关性的临床研究

Clinical Study on Relativity between Disfunction of Kidney for Activation of Qi and Renal Tubule Pathological Injury

关键词:  肾失气化  慢性肾脏病  肾小管病理损伤  临床研究

Key words:  disfunction of kidney for activation of Qi  chronic renal disease  renal tubule pathological injury  clinical study

摘要:

[目的]研究肾失气化证与慢性肾脏病肾小管病理损伤的相关性。[方法]观察临床辨证为脾肾亏虚、肾失气化证的8例慢性肾炎(肾病综合征)患者与同时辨证为其他证型6例对照,比较两组24h尿量、尿N-乙酰-β-氨基葡萄糖酶(NAG)、β-D-半乳糖苷糖(GAL)及肾小管病理损伤的差异。[结果]肾失气化组24h尿量较对照组显著减少;24h尿蛋白定量明显增高;尿NAG升高较对照组显著。该组患者肾小管病理损伤的特征为肾小管上皮颗粒变性、肾小管囊性扩张、腔内蛋白管型、灶状萎缩,肾小管以轻-中度病变为主,且较对照组显著。[结论]肾失气化形质上与肾小管病理损伤相关,病理生理上与肾小管的过度代偿、过度蛋白负荷、重吸收功能减退有关。

Abstract:

[Objective] To study the relativity between syndromes of disfunction of the kidney for the activation of Qi and the pathological injury of renal tubule in chronic renal disease. [Methods] Eight cases of chronic nephritis (nephrotic syndrome) with syndrome of deficiency of both spleen and kidney and disfunction of kidney for activation of Qi were observed clinically. Six cases with other syndromes served as control. Amount of urine in 24 hours,N-acetyl-D-glucosaminidase NAG,galactocyl GAL and the changes of pathological injury in renal tubule were compared between groups. [Results] The amount of urine in 24 hours in treatment group was less obviously than that of control group. The quantity of the urinary protein in 24 hours was increased significantly. The urine NAG was enhanced more obviously than that of control group. The renal tubule pathological injury in this group was characterized as epithelium granule degeneration of renal tubule,renal tubule cystic dilatation,protein cast,focal atrophy. Mild to moderate degree of pathologic changes existed mostly in renal tubule and there was a significant difference compared to control group. [Conclusion] The disfunction of kidney for activation of Qi is related to renal tubule pathological injury morphologically. Pathophysioilogically it related to excessive compensation,excessive protein load,decreased reabsorption function of renal tubule.