Multivariate Analysis of TCM Syndromes of IgA Nephropathy / 广州中医药大学学报

ABSTRACT

【Objective】To explore the relationship of pathological changes,clinical manifestations and results of laboratory examination with TCM syndromes in patients with IgA nephropathy.【Methods】With parameters in Memphis renal biopsy accessing system and principle syndromes and complicated syndromes in differentiation criteria of chronic nephritis as reference,pathological changes and clinical manifestations of IgA nephropathy were classified by principle component analysis and factor analysis.The regression equations of different syndromes were established after a regression analysis of the principle components of pathological changes and clinical manifestations with the standard syndromes.【Results】(1)With the parameters in Memphis renal biopsy accessing system as reference,the principle components(reflecting over 85% information of glomerular changes)of pathological changes in 123 IgA nephropathy patients were glomerulosclerosis,crescent,stroma,immunofluorescence IgA and complement 3(C_3).With principle syndromes and complicated syndromes in differentiation criteria of chronic nephritis as reference,the principle components(reflecting over 90% information of syndrome manifestations)were lassitude and weakness for deficiency syndrome,cold limbs,white tongue and slippery fur and deep-thready pulse for yang-deficiency syndrome,and dry mouth and throat,red tongue and thready pulse for yin-deficiency syndrome.For liver-stagnation syndrome,the principle components were impatience and irritability,bitterness in mouth,frequent sighing and wiry pulse;for bloodstasis syndrome,the principle components was purple tongue with ecchymosis;for phlegm-damp syndrome,the principle components were heaviness of limbs,greasy fur,abdominal distension and impaired appetite;for heat-toxic syndrome,the principle components were sore throat,purulent sore and yellowish tongue with dry fur;for damp-heat syndrome,the principle components were bitterness and stickiness in mouth,and yellowish greasy fur.(2)The regression equations of syndromes of yin deficiency,yang deficiency,yin-yang deficiency,blood stasis,phlegm damp and liver stagnation were obtained.(3)The results of non-conditional Logistic regression analysis showed that yang-deficiency syndrome was correlated with edema,the incidence of yang deficiency in edema patients being 1.6 times of that in patients without edema;yin-deficiency syndrome was positively correlated with gross hematuria,the incidence of yin deficiency in patients with gross hematuria being 1.5 times of that in patients without gross hematuria;pain in waist and back was the common signs in patients with yin deficiency,yang deficiency and yin-yang deficiency.【Conclusion】Parameters of glomerulosclerosis,crescent,stroma,immunofluorescence IgA and C_3 reflect over 85% information of glomerular changes in IgA nephropathy patients;there exists a relationship of TCM syndrome with pathological changes and clinical manifestations;yang-deficiency syndrome is correlated with edema and yin-deficiency syndrome is correlated with gross hematuria.