儿童IgA肾病中医证型与肾脏病理的关系探讨

Discussion of Relationship Between Syndrome Pattern of Chinese Medical Science and Renal Pathology In Children With IgA Nephropathy

目的:总结经肾穿刺活检明确肾脏病理的原发性IgA肾病141例住院患儿中医证型与肾脏病理类型的关系。方法:对本组资料的141例患儿在肾穿刺活检前24h内进行中医辨证分型,分析中医类型与肾脏病理光镜和免疫荧光的关系。结果:中医证型:肺卫风热,迫血下行证47例,下焦湿热,迫血下行证29例,气阴两虚证26例,肝肾阴虚证26例,脾肾气虚证13例。5种中医证型的肾脏病理类型分布明显不同。5种中医证型的肾组织免疫荧光类型在单纯IgA型;IgA+G型;IgA+M型;IgA+G+M型的分布上无明显不同。结论:中医证型与IgA肾病肾组织病理之间存在相关性,探讨其关系可以促进对本病的认识,有利于及时对此类疾病的诊断、治疗进行中医干预。

Objective：To study 141 children with biopsy-proven IgA nephropathy diagnosed at Pediatrics department of Nanjing command of jingling hospital during March 2004 to March 2010.To analyze relationship between renal pathology and Chinese medical science syndrome pattern in these children.Methods：Methodology：To discriminate syndrome pattern of Chinese medicine in 141 children during 24 hours before renal needle biopsy.To analyze relationship between syndrome pattern of Chinese medicine and pathological types or immunofluorescence types.Results：According to syndrome patterns of Chinese medicine,47 cases were type of lung defending with wind-heat and forcing blood to descend;29 cases were type of damp-heat in lower-JIAO and forcing blood to descend;26 cases were type of deficiency of both vital energy and yin;26 cases were type of hepatic and renal yin deficiency;13 cases were type of deficiency of QI in spleen and kidney.The disposition of renal pathological types was different obviously in every syndrome pattern of Chinese medicine.The disposition of renal immunofluorescence types（IgA type,IgA＋G type,IgA＋M type and IgA＋G ＋M type） was not different obviously in every syndrome pattern of Chinese medicine.Conclusion：The correlation is present between syndrome pattern of Chinese medical science and renal pathology in children with IgA nephropathy.Approaching the relations could enhance the cognition and traditional medicine intervention of the diagnosis and treatment of the disease in time.