The study of the constitution, mucosal inflammation, Chinese medicine syndrome types and clinical pathology in IgA nephropathy

摘要

Objective: This study is to investigate the constitution, mucosal inflammation, Chinese medicine syndrome types, clinical and pathological characteristics of patients with IgA nephropathy (IgA N)and to analysis their relationships in order to provide the scientfic basis and new ideas for the management of IgAN. Methods: Through the cross sectional and retrospective study, we investigated 262 patients with IgAN in the Hospital of Guangdong provincical TCM hospital and the Third Hospital of Peking Universitiy between January 2011 and January 2014. We collected the Chinese medicine syndrome types, clinical and pathological data, the constitution questionnaire and the mucosal inflammation. Results: The constitution of yin-yang harmony was the most common(40.5%), followed by qideficiency(31.3%). Upper respiratory infection, chronic periodontitis, scytitis were very common in patients with IgAN. Qi deficiency of spleen and kidney were the common type: 69.1%. Asymptomatic abnormal urinalysis(50.4% of the patients)and CKD 1(48.5%)were the most common clinical Presentation. HaasD was the most common pathological presentation(47.3%). Patients with qi deficiency of spleen and kidney and the constitution of yin-yang harmony presented with more nonmucosal inflammation, more CKD3-4, higher than the latter in the level of serum creatinine, urea nitrogen, serum CH50 and lower in GFR clinically as compared to those patients with the constitution of qi deficiency. Conclusions: IgAN onsets silently and asymptomatic abnormal urinalysis was the most common clinical type. Frequent upper respiratory infection, chronic periodontitis and recurrent scytitis were common in patients with IgAN. IgAN patients with qi deficiency of spleen and kidney and the constitution of yin-yang harmony had higher serum CH50 level, low incidence of mucosal inflammation, increased risk of declined renal function and more sever renal pathlogical changes than that of patients with qi deficiency of spleen and kid- ey and the constitution of qi deficiency.