成人原发性肾病综合征中医辨证分型与肾脏病理组织学类型相关性分析  

Correlation analysis between TCM syndrome types and pathological types of kidney in adult primary nephrotic syndrome

作　　者：郑凯林[1] 高松[2] 刘建华[2] 

机构地区：[1]福建中医药大学附属人民医院临床营养科,福州市350004 [2]南京军区福州总医院中医科,福州市350004

出　　处：《临床合理用药杂志》2017年第4期14-16,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨成人原发性肾病综合征(PNS)中医辨证分型与肾脏病理组织学类型的相关性。方法对PNS患者160例进行中医辨证分型和肾脏穿刺活检,分析中医证型与肾脏组织病理学类型的相关性。结果 160例PNS患者中医辨证分型比例由高到低依次为风水泛滥(43.75%)、湿热蕴结(30.62%)、脾肾阳虚(12.50%)、肝肾阴虚(7.50%)和肾络瘀阻(5.62%)。肾脏组织病理学类型比例由高到低依次为膜性肾病(MN,44.38%)、系膜增生性肾小球肾炎(Ms PGN,18.12%)、微小病变肾病(MCNS,14.38%)、Ig A肾病(Ig AN,13.12%)、局灶性节段性肾小球硬化(FSGS,8.75%)和其他(1.25%)。风水泛滥证患者病理类型以MN、Ms PGN多见,湿热内蕴证以MN、MCD、Ms PGN多见,肾络瘀阻证以MN为多见,其次为Ms PGN、FSGS。脾肾阳虚证、肝肾阴虚证均以MN为主。PNS患者中医证型与肾脏病理组织学类型存在显著相关性(γ=0.441,P<0.05),其中属于MN病理类型的PNS患者中医证型与MN分期存在显著相关性(γ=0.446,P<0.05)。结论成人PNS患者中医证型与肾脏病理组织学类型存在相关性,对临床诊治过程具有重要参考价值。Objective To investigate the correlation analysis between TCM syndrome types and pathological types of kidney in aduh primary nephrotic syndrome. Methods 160 patients with PNS,to investigate between TCM syndrome types and pathological types of kidney in adult primary nephrotic syndrome. Results The PNS type of TCM ratio from high to low were feng-shui flood（43.75% ） ,damp heat accumulation（30. 62% ） ,spleen kidney yang deficiency（ 12. 50% ） ,liver and kidney yin deficiency（7.50% ） and kidney collateral stasis（5.62% ）. The renal histopathological type ratio from high to low were mem- branous nephropatby （ MN,44. 38 % ）, mesangial proliferative glomerulonephritis （ MsPGN, 18. 12% ）, minimal change nephritic syndrome （ MCNS, 14. 38% ）, IgA nephropathy （ IgAN, 13. 12% ）, focal segmental glomerulosclerosis （ FSGS, 8.75 % ） and other （1.25%）. The most common renal pathological histological types in Feng-Shui flood were MN and MsPGN, and MN, MCD, MsPGN in damp heat endoretention, MN, MsPGN, FSGS in kidney collateral stasis. MN was the common type in Spleen kidney yang deficiency, and liver and kidney yin deficiency. Renal histopathological types and TCM syndromes in patients with PNS showed significant correlation（ r = 0.441, P 〈 0.05 ）. The TCM syndromes and the pathology staging in the PNS patients be- longs to MN showed significant correlation （r = 0.446,P 〈 0.05 ）. Conclusion The correlation between TCM syndromes and renal pathological types in patients with PNS, has reference value for clinical diagnosis and treatment.

关 键 词：原发性肾病综合征 中医证型 肾脏病理组织学类型 

分 类 号：R277.5[医药卫生—中医学]