老年IgA肾病80例中医证候分析

Elderly IgA nephropathy:a symptom-based analysis of 80 cases

目的探索老年IgA肾病的中医证候辨证分型识别及分布,为其中医临床诊疗提供依据。方法采用流行病学现场调查方法,收集老年IgA肾病80例的人口学、中医症状及实验室检查资料,首次运用模块化思维和基于模糊划分的迭代聚类分析方法(模糊ISODATA),在没有人为干预情况下探索老年IgA肾病中医证候的分布规律。结果中医症状包括阴虚、气虚、阳虚、湿热及血瘀症状,其出现概率均>15%;本组中脾肾气虚证4例(5%),脾肾阳虚证23例(28.7%),气阴两虚证19例(23.8%)。结论随着老龄化的进程,IgA肾病患者脾肾气虚证的比例逐渐下降,脾肾阳虚证比例逐渐上升,以气阴两虚证多见,兼证中湿热内蕴和肝郁气滞最为常见。

Objective To explore the recognition and distribution of differentiation of symptoms and signs for classification of tranditional Chinese medicine(TCM)syndrome,and to provide the base of TCM clinical diagnosis and treatment of elderly IgA nephropathy. Methods By epidemiological survey,the demography and symptoms of TCM and laboratory data were collected in 80 cases of elderly IgA nephropathy.The modularized thinking and fuzzy ISODATA were used without human intervention to explore the regularities of distribution in TCM syndrome. Results The probability of the occurrence of greater than 15% in symptoms of TCM included deficiency of yin,deficiency of qi,deficiency of yang,damp and hot,and blood stasis.The results of this study showed deficiency of spleen and kidney in 4 cases(5%),yang deficiency of spleen and kidneey in 23 cases(28.7%),deficiency of both qi and yin in 19 cases(23.8%). Conclusion With the aging process,the proportion of deficiency of spleen and kidney patients decreases,the proportion of deficiency of spleen and kidney yang syndrome increases,most commonly with qi and yin deficiency and endoretention of damp heat and stagnation of liver-qi.