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陈香美,陈以平,李平,陈建,谌贻璞,周柱亮,陈威,赵宗江,危成筠,魏日胞,邓跃毅,李建军,杜婧,周瑾,何亚妮.1016例IgA肾病患者中医证候的多中心流行病学调查及相关因素分析[J].中国中西医结合杂志,2006,(3):197-201
1016例IgA肾病患者中医证候的多中心流行病学调查及相关因素分析
A Multi-centeric Epidemiological Survey on TCM Syndrome in 1016 Patients with IgA Nephropathy and Analysis of Its Relevant Factors
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DOI:
中文关键词:  IgA肾病  中医证候  临床流行病学
英文关键词:IgA nephropathy  traditional Chinese me dicine syndrome  clinical epidemiology
基金项目:国家“十五”科技攻关项目(No.2001BA701A14a);国家自然科学基金“创新研究群体”项目(No.30121005)
作者单位
陈香美 解放军总医院肾科解放军肾病中心暨重点实验室 
陈以平 上海中医药大学附属龙华医院肾科 
李平 北京中日友好医院 
陈建 南京军区福州总医院肾科 
谌贻璞 北京中日友好医院 
周柱亮 北京军区281医院肾科 
陈威 第四军医大学西京医院肾科 
赵宗江 北京中医药大学 
危成筠 北京市中西医结合医院肾科 
魏日胞 解放军总医院肾科解放军肾病中心暨重点实验室 
邓跃毅 上海中医药大学附属龙华医院肾科 
李建军 解放军总医院肾科解放军肾病中心暨重点实验室 
杜婧 解放军总医院肾科解放军肾病中心暨重点实验室 
周瑾 解放军总医院肾科解放军肾病中心暨重点实验室 
何亚妮 北京市中西医结合医院肾科 
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中文摘要:
      目的对IgA肾病的中医证候分布规律及与主要预后指标的关系进行调查,为中西医结合诊治本病的规范化提供依据。方法采用多中心流行病学现场调查的方法,收集了1016例IgA肾病患者的人口学、中医证候学及实验室检查资料,探索IgA肾病中医证候的分布规律。结果出现概率在10%以上的中医症状包括阴虚、气虚、阳虚、湿热及血瘀症状;其中气阴两虚证最多(41·4%),脾肾阳虚证最少(8.1%);随着年龄的增长,脾肺气虚证患者比例下降,而脾肾阳虚证患者比例上升;兼证中湿热(31·6%)和血瘀(28·9%)最为常见。脾肺气虚、气阴两虚和肝肾阴虚证24h尿蛋白定量、血肌酐、尿素氮显著低于脾肾阳虚证(P<0·05);脾肺气虚、气阴两虚证血压水平显著低于肝肾阴虚证和脾肾阳虚证(P<0·05)。结论气虚、阴虚是IgA肾病的主要临床表现,中医证型与尿蛋白、高血压、肾功能损害等预后指标密切相关。
英文摘要:
      ObjectiveTo investigate the distribution pattern of TCM syndrome in patients with IgA nephropathy and its relationship with the main clinical prognostic indexes to provide a basis for the standardization of integrati ve medicine in diagnosis and treatment of IgA nephropathy. Methods Multi-centeric epidemiological field survey was adopted to collect the materials of 1016 IgA nephropathic patients, including demography, TCM sy ndrome and laboratory findings, for exploring the distribut ion pattern of TCM syndrome of IgA nephropathy patients. Results Probability of over 10% could be found in the TCM syndromes as yin deficiency, qi deficiency, yang deficiency, damp-heat and blood stasis syndrome , the highest (41.5%) was found in qi-yin deficiency syndrome and the lowest (8 .1 %) in yang deficiency of Pi and Shen. Along with the increasing of age, the perc entage of patients with Pi-Fei qi asthenia syndrome descended while those wit h Pi-Shen yang asthenia ascended. In the accompanying syndromes, damp-heat syn drome and blood stasis syndrome, with the proportion of 32.6% and 28.9% re spectively, were the most frequently encountered. The levels of 24 h urinary pro tein, serum creatinine and urea nitrogen in patients with Pi-Fei qi asthenia sy ndrome, qi-yin deficiency syndrome and Gan-Shen yin asthenia syndrome were significantly lower than those in patients with Pi-Shen yang astheni a syndrome, respectively (P<0.05), while the blood press ure in patients with Pi- Fei qi asthenia syndrome, and qi-yin deficiency syndrome were significantly lower than that in patients with Gan-Shen yin asthenia syndrome and Pi-Shen yang asthenia syndrome (P< 0.01). Conclusion (Qi-)asthenia and yin deficiency is the princip al clinical manifestation of IgA nephropathy. TCM syndrome types are close ly related with the prognostic indexes as urine protein, hypertension, renal lesion, etc.
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