Prospective study on relationship of TCM syndrome type and the Oxford classification renal pathology in 108 patients with IgA nephropathy

CHE Miaolin; TANG Lumin; CHE Lin; LIN Xinghui; GU Leyi; SHEN Huifeng; YAN Yucheng

doi:10.3969/j.issn.1671-6450.2015.05.010

Abstract：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.