原发性肾小球疾病湿热证探讨

Damp-heat syndrome of primary glomerular diseases

目的观察慢性原发性肾小球疾病的标实证和本虚证中医证候分布情况,探讨湿热证与本虚证的关系,以及湿热证的分布特点。方法选择50例慢性原发性肾小球疾病患者,根据中医证候诊断标准进行辨证分型。观察本虚证各型分布及交叉分布情况;观察不同原发病中本虚证的分布;观察慢性原发性肾小球疾病湿热证兼夹标实证分布情况;观察湿热证症状分布;观察湿热证、非湿热证中本虚证的分布。结果原发性肾小球疾病本虚证中脾肾气虚为最常见的证型,脾肾气虚最常合并脾肾阳虚;标实证中湿热为最常见的证型,可与血瘀兼夹出现;慢性肾小球肾炎和肾病综合征最常见证型均为脾肾气虚证;湿热证中出现率高的症状为腰困痛、肉眼血尿或镜下血尿,小便黄赤、灼热或涩痛不利,口干不思饮;湿热证中本虚证以脾肾气虚为主。结论慢性原发性肾小球疾病本虚证中脾肾气虚为最常见的证型,标实证中湿热证的发病率最高,并且可以合并各种肾脏病的本虚证,也可以兼夹血瘀证。

Objective To observe the syndrome distribution of tip excess syndrome and root deficiency syndrome of chronic primary glomerular diseases（PGD）,and investigate the relationship between damp-heat syndrome and root deficiency syndrome and distribution features of damp-heat syndrome.Methods The patients（n=50） with chronic PGD were chosen and classified according to the diagnostic criterion of TCM syndromes.The distributions of all types in root deficiency syndrome,distribution of root deficiency syndrome in all primary diseases,distribution of dampness-heat syndrome combining tip excess syndrome,symptoms distribution of damp-heat syndrome,and distributions of damp-heat syndrome and non-dampness-heat syndrome in root deficiency syndrome were observed.Results In the root deficiency syndrome of PGD,spleen-kidney qi deficiency was the most common syndrome type,and which was combined mostly with spleen-kidney yang deficiency.In the tip excess syndrome damp-heat syndrome was the most common syndrome type,and which was combined mostly with blood stasis.The most common syndrome type was spleen-kidney qi deficiency in both chronic glomerulonephritis and nephrosis syndrome.In the damp-heat syndrome,the common symptoms included waist pain,gross hematuria or microscopic hematuria,reddish yellow urine,hot or difficult painful or inhibited urination,and dry mouth without the desire to drink.The root deficiency syndrome in damp-heat syndrome was mainly spleen-kidney qi deficiency.Conclusion The most common syndrome type is spleen-kidney qi deficiency in the root deficiency syndrome of PGD.The occurrence rate of damp-heat syndrome is the highest in the tip excess syndrome,which can be combined with the root deficiency syndrome of different kidney diseases or blood stasis syndrome.