小儿频复发性肾病中医证型与病理类型的相关性分析

Relativity analysis of TCM syndromes and pathological types in children with frequently relapsing nephrotic syndrome

目的:探讨小儿频复发性肾病(FRNS)中医证型同病理类型之间的相关性。方法:随机选取我院2010年7月-2013年11月期间收治的诊断为FRNS的患儿50例,对其进行病理诊断和中西辨证分型,并对治疗前后患儿的血生化、尿常规、肾功能检查结果进行对比分析。结果:诊断结果表明,中医辨证分型主要为脾肾阳虚、肝肾阴虚,其次为肾虚血瘀、湿热内蕴等;病理类型主要为弥漫系膜增生性肾小球炎(MsPGN)、局灶节段性肾小球硬化+系膜增生性肾炎(FSGS+MsPGN)及IgA肾病。其中肝肾阴虚患者中多为MsPGN,湿热内蕴型患者中多为IgAN,呈正相关关系。结论:临床上可以将IgAN和MsPGN作为湿热内蕴型和肝肾阴虚型的辨证依据和客观指标,用以指导临床治疗。

Objective： To explore relativity between TCM syndromes and pathological types in children with frequently relapsing nephrotic syndrome （FRNS）. Methods： 50 children with FRNS admitted from July 2010 to November 2013 were selected randomly. The 50 children were detected and classified by syndrome differentiation; examining results of blood biochemistry, urine routine and renal function were recorded before and after treatment. Results： TCM syndrome differentiation mainly included Pishen Yangxu, Ganshen Yinxu, the sequence was Shenxu Xueyu, Shire Neiyun. Pathological types mainly included MsPGN, FSGS＋MsPGN andIgAN. Patients withGanshen Yinxu inclined to MsPGN,patients with Shire Neiyun inclined toIgAN. TCM syndromeswere positively correlated withpathological types. Conclusion： IgAN and MsPGN could be dialectical basis and objective indicators of Shire Neiyun and Ganshen Yinxu in clinical work to guide clinical treatment.