Objective To investigate the distribution pattern of TCM syndrome type and its relationship with the Ox-ford classification renal pathology in patients with IgA nephropathy.Methods One hundred and eight patients with IgA ne-phropathy diagnosed in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine were collected.Patients’ s TCM syndrome type was differentiated according to their clinical manifestations, data concerning laboratory examination and Oxford classification renal pathology.Results The highest probability (37.0%) was found in Qiyinliangxu syndrome (40 ca-ses), followed by Pishenqixu syndrome (33.3%, 36 cases), Ganshenyinxu (23.1%, 25 cases), Pishenyangxu (6.5%, 7 cases) .Hypertension and renal deficiency were common in Pishenyinxu syndrome and Pishenyangxu syndrome.Ganshenyinxu and Pishenyangxu were more likely with renal hypertension.Pishenqixu, Qiyinliangxu patients’ Leeˊs classification were re-vealed lighter, mainly was level III (61.1%and 67.5%);Ganshenyinxu revealed heavy of classification, from level III to IV (92.0%);Pishenyangxu’s Lee’ s grading was the worst, from level IV to V (100%).Syndrome differentiation and Lee grading was significantly correlated ( r =0.28, P <0.01).The proliferation of endothelial cells (E) in Qiyinliangxu syn-drome (20.0%), Pishenyangxu (28.6%) were higher than the proportion of Pishenqixu (2.8%) and Ganshenyinxu syn-drome (8.0%);renal tubular atrophy and interstitial fibrosis (T1/T2) in the Pishenyangxu accounted for the highest propor-tion (100%), Ganshenyinxu syndrome (64.0%),Pishenqixu (25.0%) and Qiyinliangxu syndrome (30.0%) accounted for a lower proportion.The Pishenyangxu syndrome’s Oxford total pathological score was the highest (12.57 ±2.51),followed by Ganshenyinxu syndrome (7.72 ±4.88), Pishenqixu (4.05 ±3.79) and Qiyinliangxu syndrome (5.08 ±3.91), there was no significant difference among them ( P >0.05).TCM syndrome types and pathological score was significantly related to Oxford score ( r =0.470, P <0.01).Pishenliangxu’s glomerular sclerosis rate was significantly higher than that of Qiyinlia-ngxu syndrome ( P <0.05);the ratio crescent in Qiyinliangxu syndrome and Ganshenyinxu syndrome were significantly high-er than that of Pishenliangxu.Conclusion Prospective study proves that the TCM syndrome type of patents with IgA nephrop-athy is correlated with the grade and severity of Oxford renal pathological changes.The syndrome types of TCM have a certain reference value for the prediction of renal pathological changes.%目的：探讨IgA肾病中医证型分布规律及其与西医临床、牛津病理的关系。方法收集上海交通大学医学院附属仁济医院确诊的IgA肾病患者108例，根据临床症候进行传统中医辨证，收集实验室检查、肾脏病理等资料，分析中医辨证分型与牛津病理关系。结果108例IgA肾病患者中医证型分为脾肾气虚36例（33．3％）、气阴两虚证40例（37．0％）、肝肾阴虚症25例（23．1％），脾肾阳虚证7例（6．5％）。气阴两虚、脾肾阳虚证以肉眼血尿多见，肝肾阴虚和脾肾阳虚证以高血压、肾功能不全多见。脾肾气虚、气阴两虚患者Lee氏分级较轻，以III 级为主（61．1％和67．5％）；肝肾阴虚分级较重，以III～IV级为主（92．0％）；脾肾阳虚Lee氏分级最重，以IV～V级为主（100％）。辨证分型与Lee氏分级显著相关（ r ＝0．28， P ＜0．01）。内皮细胞增生（E）在气阴两虚证（20．0％）、脾肾阳虚证（28．6％）所占比例高于脾肾气虚证（2．8％）、肝肾阴虚证（8．0％）；肾小管萎缩或间质纤维化（T1／T2）在脾肾阳虚证所占比例最高（100％），其次为肝肾阴虚证（64．0％），脾肾气虚证（25．0％）与气阴两虚症（30．0％）所占比例较低。脾肾阳虚证的牛津病理总积分最高为（12．57±2．51）分，其次为肝肾阴虚证（7．72±4．88）分，脾肾气虚证（4．05±3．79）分与气阴两虚证（5．08±3．91）分间差异无统计学意义（ P ＞0．05）。中医证型与牛津病理总积分显著相关（ r ＝0．470， P ＜0．01）。脾肾阳虚证出现肾小球硬化的比例显著高于气阴两虚证（ P ＜0．05）；气阴两虚证与肝肾阴虚证新月体出现的比例显著高于脾肾气虚证。结论 IgA肾病中医证型与牛津病理组织学改变及病变程度显著相关，中医临床辨证分型对预测肾脏病理改变程度有一定的参考价值。
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