Ⅳ型狼疮性肾炎中医证型与肾间质病变的相关性探讨  

Correlation between Various Syndrome Patterns and Renal Interstitial Lesions in Lupus Nephritis of Type Ⅳ

作　　者：张绍杰[1] 汤水福[2] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院肾病科,广东广州510405

出　　处：《辽宁中医杂志》2016年第6期1200-1202,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：广东省自然科学基金(S201301002219)

摘　　要：目的:探讨Ⅳ型狼疮性肾炎(LN)中医证型与肾间质病变及活动性指数(AI)、慢性化指数(CI)的相关性。方法:回顾性研究收集经肾穿刺活检诊断为Ⅳ型LN的患者56例,根据有无肾间质病变分为两组。所有患者分别按中医辨证分为脾肾气虚型、热毒炽盛型、脾肾阳虚型、气阴两虚型、肝肾阴虚型5个主症证型及血瘀证、湿热证2个兼症证型。分析主症、兼症与肾间质病变、活动性指数(AI)、慢性化指数(CI)之间的相关性。结果:(1)两组患者中医主症证型分布比较,差异无统计学意义(P=0.146);各主症证型的AI比较,差异无统计学意义(P=0.222);脾肾气虚型与热毒炽盛型的CI比较,差异有统计学意义(P=0.028)。(2)两组患者中医兼症证型比较,差异有统计学意义(P=0.003);两兼症证型的AI比较,差异无统计学意义(P=0.86);而CI比较,差异有统计学意义(P=0.004)。(3)肾间质病变组与无肾间质病变组两组患者的AI、CI比较,差异均有统计学意义(P<0.05)。结论:中医主症证型与Ⅳ型LN患者肾间质病变无明显相关性,而兼症证型中血瘀证与肾间质病变具有明显相关性,肾间质病变以血瘀证为主。LN合并肾间质病变的患者疾病活动性更强,且易导致肾脏的慢性损害。Objective： To discuss the correlation between syndrome patterns and renal interstitial,active index（ AI） and chronic index（ CI） in lupus nephritis of type Ⅳ. Methods： A retrospective study was carried out in 56 LN patients of type Ⅳ who had performed renal biopsy,and then these patients were divided into two groups by presence of renal interstitial lesions. The patients were differentiated into five main syndrome patterns： spleen- kidney qi deficiency,excessive heat- toxicity,spleen- kidney Yang deficiency,Qi- Yin deficiency,liver- kidney Yin deficiency and two accompanied syndrome patterns： blood stasis and damp-heat. Analyze the correlations among syndrome patterns and renal interstial lesions,AI and CI. Results：（ 1） The five main syndrome patterns in two groups had no statistical difference（ P = 0. 146）. AI in different patterns had no statistical difference（ P =0. 222）. CI was differed in spleen- kidney qi deficiency and excessive heat- toxicity（ P = 0. 028）.（ 2） The two accompanied syndrome patterns in two groups had statistical difference（ P = 0. 003）. AI in different patterns had no statistical difference（ P =0. 86）. CI was differed in two patterns（ P = 0. 004）.（ 3） AI and CI were both differed in the two groups by presence of renal interstial lesions（ P 〈 0. 05）. Conclusion： There is no correlation between five master syndrome patterns and renal interstial lesions in lupus nephritis of type Ⅳ,but there is significant correlation between blood stasis and renal interstial lesions. The main pattern of renal interstitial lesions is blood stasis. The activity of lupus nephritis combined renal interstitial lesions is more stronger,and easy to cause chronic damage of the kidney.

关 键 词：狼疮性肾炎 中医证型 肾间质 

分 类 号：R593.242[医药卫生—内科学]