慢性移植肾肾病患者中医辨证分型与Banff病理分级关系探讨  

Relationship between syndrome differentiation classifi cation of TCM and Banff classifi cation of renal allograft pathology in patients with chronic allograft nephropathy

作　　者：李夏玉[1] 贺学林[1] 李恒[1] 程军[1] 范永升 陈江华[1] 

机构地区：[1]浙江大学医学院附属第一医院,杭州310003 [2]范永升全国名老中医药专家传承工作室,杭州310005

出　　处：《中华中医药杂志》2014年第3期739-741,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药科技计划项目(No.2010ZA052;No.2012ZB088)~~

摘　　要：目的:探讨慢性移植肾肾病(CAN)患者中医辨证分型与移植肾Banff病理分级的相关性。方法:按临床及病理诊断标准选择CAN患者84例,对所有患者进行中医辨证,并按Banff 07诊断及分级标准对患者移植肾组织病理学进行Banff分级评定。结果:随着中医主证由肺肾气虚证、气阴两虚证及肝肾阴虚证、脾肾阳虚证的演变,Banff病理逐渐加重。肺肾气虚证以Banff病理Ⅰ-Ⅱ级为主;气阴两虚证及肝肾阴虚证各有63.0%及57.1%的为Banff病理Ⅱ级,脾肾阳虚证64.3%的患者为Banff病理Ⅲ级。78.6%(66例)CAN患者兼血瘀证,Banff病理Ⅰ、Ⅱ、Ⅲ级患者中兼血瘀证分别为50%、82.9%、86.2%。85.7%(72例)CAN患者兼湿阻证,Banff病理Ⅱ级患者56.1%兼湿热,Banff病理Ⅲ级患者62.1%兼湿浊。结论:CAN患者中医辨证分型与Banff病理分级严重程度相关。Objective： To investigate the relationship between syndrome of traditional Chinese medicine （TCM） and Banff classification of renal allograft pathology in patients with chronic allograft nephropathy （CAN）. Methods： 84 patients with CAN based on clinical and pathological diagnostic criteria, were assigned to be evaluated with syndrome differentiation classification of TCM and Banff classification of renal allografi pathology according to diagnostic criteria of Banff 07. Results： As the patients＇ syndromes of TCM from qi-deficiency of the lung and kidney, deficiency of both qi and yin or yin-deficiency of the kidney and liver, and yang-deficiency of spleen and kidney, Banff classification of renal allograft pathology aggravated gradually. qi-deficiency type of the lung and kidney was mainly seen in Banff classification Ⅰ-Ⅱ, 63% patients with type of deficiency of both qi and yin, 57.1% patients with yin deficiency type of the kidney and liver were Banff classification Ⅱ. 64.3% patients with yang deficiency of spleen and kidney was Banff classification Ⅲ. Type of stasis was seen in 66 （78.6%） CAN patients, with 50%, 82.9%, 86.2% of Banff classification Ⅰ, Ⅱ, Ⅲ. Type of dampness obstruction was seen in 72 （85.7%） CAN patients. 56.1% of patients with Banff classification Ⅱ was type of dampness-heat, 62.1% of patients with Banff classificationⅢ was type of dampness turbidity. Conclusion： There was significant correlation between syndrome of TCM and Banff classifcation of renal allograft pathology in patients with CAN.

关 键 词：慢性移植肾 肾病 中医证型 移植肾病理Banff分级 

分 类 号：R699.2[医药卫生—泌尿科学]