原发性肾病综合征中医证型和病理分型相关性分析

A correlation analysis of TCM syndromes and pathological types of primary nephrotic syndrome

目的:分析并研究原发性肾病综合征中医证型和病理分型的相关性。方法:本研究采用前瞻性研究,选择我院在2014年3月-2016年7月收治的150例肾病综合症患者作为研究对象,治疗前1~3日采集患者的中医四诊资料,对患者进行中医辨证,记录肾脏的病理资料,并进行分析整理,探讨中医辨证分型和肾脏病理分型的相关性。结果:从性别方面来看,肾病综合征的男性比例明显高于女性比例,大约为2∶1;从年龄来看,患者的发病年龄一般为40岁左右,各个症型的年龄差异无统计学意义,但是各种病理类型的年龄比较存在明显差异,P<0.05。中医证型当中,风水泛滥证最为多见,其次是湿热蕴结证、脾肾阳虚证、肾络瘀阻证。肾脏病理表现以出现膜性肾病为主,其次是系膜增生性肾小球炎、肾小球轻微病变型。中医证型和肾脏病理类型存在一定的关联,但关联度并不高,各个中医证型之间风水泛滥病理类型的构成有差异,而其他的证型病理类型构成不存在差异。结论:原发性肾病综合征的中医证型和病理分型具有相关性,其中以风水泛滥为主,但是关联度并不高,临床上在对患者进行治疗的时候需要根据实际情况加以分析。

Objective To analyze and study the correlation between TCM syndromes and pathological types of primary nephrotic syndromes. Methods： 150 patients were selected as the subjects. Patients were collected before renal transplantation. TCM syndromes and pathological data were recorded and organized, to explore the classifcation of TCM syndromes and pathological type. Results： About nephrotic syndrome, number of men was significantly more than women, about 2：1. The age of onset is generally about 40 years old; there was no statistically signifcant diference in the age of syndromes; and there were signifcant diferences in the age of various pathological types, P〈0.05. In TCM syndromes, the most common syndrome was the Fengshui Fanlan syndrome, following by the Shire Yunjie syndrome, the Pishen Yangxu syndrome, the Shenluo Yuzu syndrome. The pathological type mainly was membranous nephropathy, following by massage hyperplastic glomerulosclerosis, glomerular minor lesions. There is a little relevance between TCM syndromes and renal pathology types. There was a diference between the pathological types in the Fengshui Fanlan syndrome; and there was no diference in the other syndromes. Conclusion： There is a correlation between TCM syndromes and pathologic types of primary nephrotic syndrome, among the Fengshui Fanlan syndrome, with a little correlation. In clinic, it is necessary to be treated according to the actual situation.