摘要
目的通过分析气阴两虚型慢性肾炎中医证型与肾脏病理积分的相关性,探讨中医辨证与肾脏病理之间的关系。方法对68例气阴两虚型慢性肾炎患者行肾组织活检,分别做电镜、光镜、免疫荧光染色以及组织化学法染色,运用Katafuchi R半定量评分方法对肾穿刺病理报告结果进行整理归纳,探讨气阴两虚型慢性肾炎患者的病理表现积分与中医证候分布的关系。结果 68例肾组织活检患者中,3种中医证型(气阴两虚伴血瘀兼湿热、气阴两虚伴血瘀、气阴两虚伴湿热)肾脏病理积分比较,气阴两虚伴血瘀兼湿热者的系膜增殖积分及肾小管萎缩积分最高(P<0.05);气阴两虚伴湿热者血管壁增厚积分最高(P<0.05)。结论气阴两虚伴湿热兼血瘀者的系膜增殖与肾小管萎缩最严重,说明该证型的愈后更差,应该对其治疗更积极,随访更密切。气阴两虚伴湿热者的血管壁增厚最严重,说明该证型患者最易出现高血压等并发症,应在治疗中密切随访患者血压情况。
Objective To analyze the correlation between renal pathological score and Chinese medical syndrome differentiation in chronic nephritis with deficiency of qi and yin, and discuss the relationship between Chinese medical syndrome differentiation and renal pathology. Methods Sixty-eight patients of chronic nephritis with deficiency of qi and yin were examined by renal biopsy. The electron microscopy, light microscopy, immunofluorescence staining and histochemical staining were performed, respectively. Katafuchi R semi-quantitative scoring was used to summarize the pathological report results of renal puncture, and the relationship between pathological score and Chinese medical syndrome distribution in chronic nephritis patients with deficiency of qi and yin was analyzed. Results Among the 68 patients with renal biopsy, the renal pathological scores of 3 kinds of Chinese medical syndromes(deficiency of qi and yin with blood stasis and damp heat, deficiency of qi and yin with blood stasis, deficiency of qi and yin with damp heat) were compared. For the patients of deficiency of qi and yin with blood stasis and damp heat, the score of mesangial proliferation and the score of tubular atrophy were the highest(P<0.05). For the patients of deficiency of qi and yin with damp heat, the score of vascular wall thickening was the highest(P<0.05). Conclusion The patients of deficiency of qi and yin with blood stasis and damp heat show the most serious mesangial proliferation and tubular atrophy, which suggests that the prognosis of this syndrome may be worse, and these patients should be treated more actively and followed-up more closely. The patients of deficiency of qi and yin with damp heat show the most serious vascular wall thickening, which suggests that patients with this syndrome are most likely to have complications such as hypertension, and the blood pressure should be closely followed-up during the treatment.
作者
梁婷玉
杨华
王子元
沈沛成
LIANG Tingyu;YANG Hua;WANG Ziyuan;SHEN Peicheng(Department of Pathology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Nephropathy,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《上海中医药杂志》
2020年第S01期14-16,共3页
Shanghai Journal of Traditional Chinese Medicine
基金
上海中医药大学附属曙光医院四明青年基金项目(SGKJ2018-20).
关键词
慢性肾小球肾炎
中医证型
肾脏病理
chronic nephritis
Chinese medical syndrome
renal pathology
作者简介
梁婷玉,女,硕士研究生,主管技师,主要从事肾脏病理研究工作;通信作者:沈沛成,主任医师,硕士研究生导师。E-mail:spc111215@163.com
