成人特发性膜性肾病激素敏感性与中医证型的相关性研究

Relationship of corticosteroid sensitivity with TCM Syndromes in Adult Patients with Idiopathic Membranous Nephropathy

目的探讨成人特发性膜性肾病（IMN）激素敏感性与中医辨证分型的相关性。方法收集原发性肾病综合征（PNS）患者200例,其中实验组（IMN）38例,对照组（非IMN）162例。根据患者对激素的的效应,将实验组分为实验A组（激素敏感）8例,实验B组（激素不敏感）30例;对照组分为对照A组（激素敏感）79例,对照B组（激素不敏感）83例。对200例患者进行中医辨证,分析IMN患者激素敏感性与中医证型的相关性。结果①实验组患者年龄大于对照组（P〈0.05）;与对照A组相比,对照B组女性多（P〈0.05）,且年龄较大（P〈0.01）。②实验组对激素敏感性低于对照组（P〈0.05）。③与对照组相比,实验组中气（阳）虚证、血瘀证较多（P〈0.05）,而阴虚证和湿热证较少（P〈0.01）;与对照B组相比,对照A组气（阳）虚证和风湿证较多（P〈0.05~0.01）,阴虚证较少（P〈0.05）。结论①在PNS患者中,IMN患者年龄偏大,但年龄与激素效应无明显的相关性;非IMN患者激素不敏感者年龄偏大。②激素敏感性与病理类型有关,IMN患者对激素不敏感。③IMN患者中医证型的气（阳）虚证、血瘀证明显多于非IMN患者。

Objective To assess the correlation between corticosteroid sensitivity and TCM syndromes in adult patients with Idiopathic Membranous Nephropathy（IMN）.Methods A total of 200 patients with primary nephrotic syndrome（PNS）was enrolled in this study,including 38 patients of IMN in experimental group and 162 patients of other types of PNS in control group.According to the reaction of corticosteroid,experimental group was divided into experimental group A who was sensitive to corticosteroid and experimental group B who was insensitive to corticosteroid,and control group was also divided into control group A who was sensitive to corticosteroid and control group B who was insensitive to corticosteroid.All patients were differentiated according to differentiation of TCM syndromes.Results 1）the age of experimental group was higher than control group（P 0.05）;the age of control group B was higher than control group A（P 0.01）,and woman in control group B had a higher incidence than control group A（P 0.05）;2）the experimental group had a lower corticosteroid sensitivity than control group（P 0.05）;3）qi（yang） deficiency syndrome and blood stasis syndrome in experimental group had a higher incidence than control group（P 0.05）,but ying deficiency syndrome and damp-heat syndrome had a lower incidence than control group（P 0.01）;qi（yang） deficiency syndrome and rheumatism syndrome in control group A had a higher incidence than control group B（P 0.01~0.05）,but ying deficiency syndrome had a lower incidence than control group B（P 0.05）.Conclusions 1）Our study finds that the age of IMN patients was order than other types of PNS,but the age didn t lead to occurrence of steroid-resistant patients of IMN;on the contrary,among other types of PNS patients,the age of steroid-resistant patients was higher than steroid-sensitive patients;2）Our study confirms that corticosteroid sensitivity and pathologic types in PNS patients is connected,and IMN is insensitive to corticosteroid;3）In this study,we have discovered qi（yang） deficiency syndrome and blood stasis syndrome have a higher incidence in the patients of IMN than the other types of PNS.