【摘要】 目的:探讨中医体质对脾肾气虚型IgA肾病病理的影响及临床病理相关性。方法:采用横断面调查方法,根据患者临床表现由中医师进行辨证分型,属于脾肾气虚型的103例IgA患者再填写"中医体质分类判定表"确立体质,收集实验室检查、肾脏病理等资料进行分析,病理比较采用katafuchi评分标准。结果:气虚质病理积分最轻,平和质次之,夹湿质最重,肾小球积分气虚质显著低于平和质(P<0.05),肾血管积分夹湿质显著高于平和质(P<0.05);气虚质的尿素氮、肌酐和尿酸均显著低于夹湿体质(P<0.05),尿素氮也显著低于平和质(P<0.05),平和质的尿酸、白蛋白显著低于夹湿体质(P<0.05),夹湿体质C3、C4最高。结论:脾肾气虚型IgA肾病患者的体质与病理积分及临床指标显著相关,即使同一证型患者,不同体质的预防和治疗应该有所不同,提示在辨证的同时进行中医体质辨识对肾脏病理的预测、诊断和治疗上有一定的参考价值。更多还原

【Abstract】 Objective: To investigate the effect of TCM physique on the pathology of Spleen-kidney deficiency type with Ig A nephropathy and clinicopathology correlation.Methods: We used a cross-sectional survey to collect laboratory and renal pathology results for analysis.A Chinese physician determined the TCM syndrome type of patients according to the clinical manifestation,then the 103 patients of Spleen-kidney deficiency filled out the "Traditional Chinese Medicine Physique Classification Decision Table"to establish the TCM physique.Katafuchi grade was used for pathology comparison.Results: The lowest Katafuchi score was Qi deficiency physique,secondly was normal physique,the highest was damp physique( including phlegm-dampness and damp heat physique.) The glomerulus score of Qi deficiency physique was significant lower than normal physique( P < 0.05).The renal vascular score of damp physique was significant higher than normal physique( P < 0.05).Urea nitrogen,creatinine and uric acid of qi deficiency physique were lower than damp physique and normal physique( P < 0.05).Damp physique was higher than normal physique in uric acid,albumin and total protein and washighest in C3 and C4( P < 0.05).Conclusion: The discrepancy of Cliniopathology in TCM physiques of Spleen-kidney deficiency with Ig A nephropathy suggested that prevention and treatment of TCM physiques should be different even for the same TCM syndrome type with Ig A nephropathy.Identification the TCM physique based on syndrome differentiation may be worth of prognosis,diagnosis and treatment in renal pathology.更多还原