46例IgA肾病患者肾脏病理表现与中医辨证分型的相关性研究

Correlation study between renal pathology and differentiating typing of TCM in 46 patients wth IgA nephropathy

关键词:  IgA肾病  病理表现  辨证分型

Key words:  IgA nephropathy  pathology  differentiation of symptoms and signs for classification of syndrome

摘要:

[目的]研究IgA肾病在光镜下的病理表现(Lee氏分级)与中医辨证分型的相关性。[方法]收集已做肾活检,经免疫荧光病理检查确诊为IgA肾病的46例住院患者,记录每个患者的光镜病理表现,并进行中医辨证分型。[结果]IgA肾病病理表现和中医辨证相关(P<0.01)。肾脏病理表现采用Lee氏分级法,其中Lee氏Ⅰ级、Lee氏Ⅱ级中医证型多为热毒内扰和(或)湿热壅滞;Lee氏Ⅲ级、Ⅳ级中医证型多为脉络瘀阻和(或)虚实夹杂;Lee氏Ⅴ级中医证型为虚实夹杂,因例数少而无统计学意义。[结论]IgA肾病的病理表现与中医的辨证分型有一定的相关性,微观变化与中医辨证结合拓展了中西医结合诊治IgA肾病的思路。

Abstract:

[Objective] To study the correlation between pathologic appearances under light microscopy in IgA kidney disease(Lee’s classification) and TCM syndrome differentiation.[Methods] Fourty-six patients diagnosed as IgA nephropathy via renal immunofluorescence pathology were collected,recording their pathologic changes under light microscopy and making differentiated typing.[Results] The IgA kidney pathological appearance and its TCM syndrome differentiation were correlated.(P<0.01).Renal pathology grading was performed by Lee’s classification method.Among them,more patients with Lee’s Ⅰ,Lee’s Ⅱ had TCM syndrome type of inner disorder of toxic heat and(or) humid warm obstruction,while patients with Lee’s Ⅲ level or Ⅳ level had blockage of the vessel and(or) deficiency syndrome mingling with excess syndrome and Lee’s Ⅴ level had deficiency syndrome mingling with excess syndrome.It was not statistical significant because less number.[Conclusion] There are some correlation between IgA kidney pathology and TCM syndrome.Micro-change and the combination of TCM syndrome differentiation may expand the diagnosis and treatment of IgA nephropathy.