【摘要】：目的：1.比較皮膚黏膜炎癥在慢性腎炎與普通人群中的發(fā)病情況2.鑒于文獻中已證實皮膚黏膜炎癥與IgA腎病的因果關系,我們以IgA腎病作為模型,研究皮膚黏膜炎癥在IgA腎病人群中為什么高發(fā),與哪些因素有關,探索反復發(fā)生的原因及可能的防治對策。3.比較不同病理類型慢性腎炎患者群體中皮膚黏膜炎癥的發(fā)病情況,找出不同病理類型之間有差異的各種臨床指標,為采用臨床表型預測腎臟病理類型做出初步探索4.鑒于以往的研究發(fā)現(xiàn)一種證型可以包含多種體質(zhì),我們進一步探討體質(zhì)、證型共同對慢性腎炎臨床病理的影響方法：1.收集85例腎源性孤立性鏡下血尿患者和85例普通人群的皮膚黏膜炎癥的資料進行病例對照研究,比較皮膚黏膜炎癥在慢性腎炎與普通人群的發(fā)病情況。2.采用流行病學現(xiàn)場調(diào)查方法,收集162例IgA腎病患者皮膚黏膜炎癥、炎癥誘因及中醫(yī)體質(zhì)的資料,研究皮膚黏膜炎癥在IgA腎病人群中的高發(fā)原因,分析中醫(yī)體質(zhì)與皮膚黏膜炎癥、炎癥誘因的相關性,探索可能的防治對策。3.采用流行病學調(diào)查方法,收集226例已行腎活檢明確病理類型的慢性腎炎患者皮膚黏膜炎癥、臨床特征、中醫(yī)體質(zhì)及中醫(yī)證型的資料,比較不同病理類型慢性腎炎患者群體中皮膚黏膜炎癥的發(fā)病情況,找出不同病理類型之間有差異的各種臨床指標。4.研究方法和調(diào)查內(nèi)容同第三部分,收集104例脾腎氣虛型IgA腎病不同體質(zhì)的臨床資料和102例膜性腎病不同體質(zhì)的臨床資料,分析體質(zhì)、證型共同對腎臟臨床病理的影響,為病理預后判斷提供依據(jù)。結(jié)果：1.慢性腎炎與普通人群皮膚黏膜炎癥患病率比較腎源性孤立性血尿病例組和對照組基線資料無差異,皮膚黏膜炎癥比較顯示：血尿組有皮膚黏膜炎癥的發(fā)生率比對照組高,炎癥種類越多,兩組比較越有統(tǒng)計學意義。不同種類的皮膚黏膜炎癥比較中,每年有無感冒、感冒≥3次／年,每年有無口腔潰瘍、口腔潰瘍≥2次／年,慢性咽炎、慢性扁桃體炎、慢性鼻炎、反流性食管炎、慢性皮膚病兩組差異有統(tǒng)計學意義。急性炎癥如感冒和口腔潰瘍,每年發(fā)作次數(shù)越多,兩組比較越有統(tǒng)計學意義。為什么反復或慢性皮膚黏膜炎癥在慢性腎炎群體中發(fā)病率很高?這些皮膚黏膜炎癥的發(fā)生與哪些因素有關?它們與腎臟病的發(fā)生和發(fā)展有什么關系?2.IgA腎病皮膚黏膜炎癥及相關因素的調(diào)查研究2.1 162例IgA腎病患者一般情況分析162例患者中男性92例,女性70例,平均年齡為35.9±12.5歲,平均病程42.9±35.5月,其中以腎病綜合征起病有1 9例(11.7%),以肉眼血尿起病有25例(15.4%),起病時伴鏡下血尿有150例(92.6%)。2.2 162例患者的中醫(yī)體質(zhì)分布162例IgA腎病患者中醫(yī)體質(zhì)分布以平和質(zhì)78例(48.1%),氣虛質(zhì)23例(14.2%),陽虛質(zhì)20例(12.3%)為主。兼夾體質(zhì)有三種,氣郁質(zhì)7例(4.3%),特稟質(zhì)15例(9.3%),和血瘀質(zhì)6例(3.7%)。2.3 IgA腎病患者的皮膚黏膜炎癥分布反復或慢性皮膚黏膜炎癥一共有9種,其中有炎癥141例(87%),無炎癥有21例(13%),慢性鼻炎患者24例(14.8%),慢性咽炎61例(37.7%),慢性扁桃體炎28例(17.3%),牙齦炎或牙周炎68例(42%),反復口腔潰瘍28例(17.3%),反復上呼吸道感染43例(26.5%),慢性腸炎35例(21.6%),慢性胃炎或十二指腸潰瘍31例(19.1%),皮膚炎癥(蕁麻疹或痤瘡)71例(43.8%)。一個患者可有多種皮膚黏膜炎癥炎癥,數(shù)目多集中在2-3種。2.4皮膚黏膜炎癥的誘因分布我們調(diào)查了反復或慢性皮膚黏膜炎癥的誘因分布,主要是氣候變化70例(43.2%),飲食因素37例(22.8%),失眠因素44例(27.2%),勞累因素48例(29.6%),情緒因素11例(6.8%),過敏因素19例(11.7%)。2.5中醫(yī)體質(zhì)與炎癥類型比較9種炎癥類型與中醫(yī)體質(zhì)比較發(fā)現(xiàn),某些炎癥在不同體質(zhì)之間存在分布差異,慢性鼻炎,氣虛質(zhì)比平和質(zhì)發(fā)病率高,有統(tǒng)計學意義。與平和質(zhì)相比,反復上呼吸道感染氣虛質(zhì)和陽虛質(zhì)發(fā)病率高,有統(tǒng)計學意義。與平和質(zhì)相比,慢性胃炎或十二指腸潰瘍,陰虛質(zhì)發(fā)病率高,有統(tǒng)計學意義。和平和質(zhì)相比,濕熱質(zhì)反復或慢性皮膚炎癥發(fā)病率高,有統(tǒng)計學意義(P0.05)。2.6中醫(yī)體質(zhì)與炎癥誘因的比較在體質(zhì)與炎癥誘因的比較中我們也發(fā)現(xiàn),在不同黏膜炎癥誘因下體質(zhì)分布有差異,例如氣候變化的誘因?qū)е碌难装Y以氣虛質(zhì)和陽虛質(zhì)患者比例較高,與平和質(zhì)和痰濕質(zhì)比較有統(tǒng)計學意義,飲食因素誘發(fā)或加重皮膚黏膜炎癥的患者以濕熱質(zhì)和陰虛質(zhì)較多,與平和質(zhì)和陽虛質(zhì)相比,有統(tǒng)計學意義。過敏因素誘發(fā)炎癥患者以痰濕質(zhì)居多,與平和質(zhì)相比有統(tǒng)計學意義(P0.05)。皮膚黏膜炎癥在IgA腎病患者中發(fā)病率很高,與中醫(yī)體質(zhì)相關,那么在其他病理類型的慢性腎炎中發(fā)病情況如何?體質(zhì)、證型能否用于預測慢性腎小球腎炎的不同病理類型?3.不同病理類型慢性腎炎的皮膚黏膜炎癥比較及臨床表型初步探索3.1 226例患者的一般基線資料226例患者年齡大多集中在18歲到55歲之間,男性133例,女性93例,病程中位數(shù)為38(12,48)月,其中局灶節(jié)段硬化型腎小球腎炎1例(0.4%),IgAN組136例(60.2%),MN伴系膜IgA沉積(IgA+MN)組患者有15例(6.6%),MN患者有61例(27%),MCD組為13例(5.8%)。3.2 226例患者的中醫(yī)證型和中醫(yī)體質(zhì)資料226例患者中有3例缺少中醫(yī)體質(zhì)和證型的資料,余223例患者進行統(tǒng)計分析,其中中醫(yī)證型分布以脾腎氣虛152例(68.2%)和脾腎陽虛48例(21.5%)居多,標證分布以水濕證32例(14.3%),濕濁證48例(21.5%),濕熱證58例(26%),血瘀證32例(14.3%)較為常見。中醫(yī)體質(zhì)中以平和質(zhì)78例(35.4%)最多,其次是氣虛質(zhì)29例(13.0%),陽虛質(zhì)39例(17.5%),痰濕質(zhì)40例(17.9%)。3.3皮膚黏膜炎癥對慢性腎炎不同病理類型的影響FSGS例數(shù)較少,故未納入比較。結(jié)果顯示慢性鼻炎、慢性咽炎、反復或慢性牙齦炎/牙周炎、反復皮膚痤瘡在不同病理分布中差異有統(tǒng)計學意義(P0.05),兩兩比較后反復或慢性牙齦炎/牙周炎以IgA+MN、MN患者居多,與IgAN比較有統(tǒng)計學意義,IgA+MN比例高于MCD。IgAN上呼吸道炎癥和皮膚炎癥居多,和MN相比有統(tǒng)計學意義(P0.05)。3.4慢性腎炎不同病理類型臨床參數(shù)的比較列出了20種有統(tǒng)計學意義的指標,包括年齡、病史、臨床指標、中醫(yī)體質(zhì)和證型等,進一步兩兩比較后發(fā)現(xiàn),IgAN年齡、腎病綜合征比例、腎功能異常比例、24小時尿蛋白、白蛋白、血肌酐與其他三組比較有統(tǒng)計學意義(P0.01),MCD患者年齡低于MN(P0.01),MN組血清IgA、C3低于IgAN組,IgE高于IgAN組,結(jié)果有統(tǒng)計學意義(P0.01),體質(zhì)與證型比較中,MCD組脾腎陽虛證和陽虛質(zhì)比例較高,與IgAN組相比有統(tǒng)計學意義(P0.01),IgAN痰濕質(zhì)比例較高,與MN組比較有統(tǒng)計學意義(P0.01)。在本研究中,發(fā)現(xiàn)不同病理類型腎炎之間中醫(yī)體質(zhì)和證型分布有差異,我們以往的研究還發(fā)現(xiàn)有時一種證型可以包含多種體質(zhì),而這些是否會對腎臟臨床病理產(chǎn)生影響?4.中醫(yī)體質(zhì)、證型與慢性腎炎臨床病理的相關研究4.1脾腎氣虛型IgA腎病不同體質(zhì)的臨床病理比較4.1.1三種體質(zhì)腎臟病理Katafuchi積分以及臨床指標比較我們納入了104例脾腎氣虛型患者,中醫(yī)體質(zhì)辨識主要為三種體質(zhì),平和質(zhì)40例、氣虛質(zhì)19例和夾濕體質(zhì)(包括濕熱質(zhì)和痰濕質(zhì))45例。氣虛質(zhì)腎小球積分低于平和質(zhì),夾濕質(zhì)腎血管積分高于平和質(zhì),差異有統(tǒng)計學意義,腎小球積分和總積分都有氣虛質(zhì)最低,其次平和質(zhì),夾濕質(zhì)最高的趨勢�？偰懝檀�、甘油三酯、肌酐和尿酸的比較中都有氣虛質(zhì)最低,其次是平和質(zhì),夾濕質(zhì)最高的趨勢。4.2膜性腎病不同體質(zhì)的臨床病理比較4.2.1基線和病理比較102例膜性腎病中,中醫(yī)證型主要為脾腎氣虛68例(64.2%)和脾腎陽虛30例(28.3%),肺腎氣虛1例(0.9%)、氣陰兩虛2例(1.9%)、陰陽兩虛1例(0.9%)例數(shù)較少未納入比較。隨訪中無特稟質(zhì)、氣郁質(zhì)及血瘀質(zhì),痰濕質(zhì)和濕熱質(zhì)均為夾濕體質(zhì),因各自例數(shù)偏少,故合并為一組,脾腎陽虛型患者除陽虛質(zhì)以外,其他體質(zhì)例數(shù)較少,故合并為非陽虛質(zhì)一組。其中平和質(zhì)43例(42.2%),氣虛質(zhì)11例(10.8%),夾濕質(zhì)14例(13.7%),陽虛質(zhì)24例(23.5%),非陽虛質(zhì)6例(5.9%)。這五種體質(zhì)在年齡、病程、高血壓分布中無統(tǒng)計學意義。五組患者性別分布有統(tǒng)計學意義。體質(zhì)指數(shù)比較中,脾腎氣虛型患者三種體質(zhì)中平和質(zhì)、陽虛質(zhì)最低,氣虛質(zhì)、非陽虛質(zhì)其次,夾濕質(zhì)最高,差異有統(tǒng)計學意義。脾腎氣虛夾濕型患者的Ⅱ期膜性腎病的比例高于其他體質(zhì)類型,其次是平和質(zhì)脾腎氣虛型,氣虛質(zhì)脾腎氣虛型比例最小,差異有統(tǒng)計學意義。4.2.2五種體質(zhì)實驗室檢查結(jié)果比較腎功能方面,夾濕質(zhì)血肌酐高于氣虛質(zhì)和陽虛質(zhì)。24小時尿蛋白中,夾濕質(zhì)最高。血肌酐和24小時尿蛋白比較中都有氣虛質(zhì)最低,平和質(zhì)其次,夾濕質(zhì)最高的趨勢。陽虛質(zhì)臨床病理比較并不比非陽虛質(zhì)重。結(jié)論：1.皮膚黏膜炎癥在腎源性血尿患者中發(fā)病率更高。其中每年有無感冒,感冒≥3次/年、慢性咽炎、扁桃體炎和鼻炎,有無口腔潰瘍、口腔潰瘍≥2次/年,反流性食管炎,慢性皮膚病在腎源性血尿組發(fā)生率高。2.IgA腎病患者皮膚黏膜炎癥發(fā)病率很高。3.IgA腎病很可能是從自身炎癥性疾病到自身免疫性疾病的大疾病譜。4.中醫(yī)體質(zhì)與皮膚黏膜炎癥類型相關,尤其是氣虛質(zhì)、陽虛質(zhì)與上呼吸道炎癥,陰虛質(zhì)與慢性胃炎,濕熱質(zhì)與反復或慢性皮膚炎癥。5.中醫(yī)體質(zhì)與炎癥誘因相關,尤其是氣虛質(zhì)、陽虛質(zhì)與氣候變化因素,濕熱質(zhì)、陰虛質(zhì)與飲食因素,痰濕質(zhì)與過敏因素,這些可以指導個體化預防。6.體質(zhì)與環(huán)境因素的相互作用可能是IgA腎病產(chǎn)生的重要基礎。7.不同病理類型的慢性腎炎患者皮膚黏膜炎癥分布有差異。8.四種病理類型之間還有許多其他指標(包括臨床和實驗室指標、中醫(yī)體質(zhì)及中醫(yī)證型)有差異。9.聯(lián)合這些指標可以為下一步建立預測模型提供依據(jù)。10.如果把氣虛質(zhì)發(fā)展至脾腎氣虛型稱為先天稟賦不足造成的氣虛,平和質(zhì)、夾濕質(zhì)發(fā)展至脾腎氣虛型稱為后天失養(yǎng)導致的氣虛,無論是IgA腎病還是膜性腎病的比較中都有先天稟賦不足導致的氣虛的臨床病理輕于后天失養(yǎng)導致的氣虛。
[Abstract]:Objective: 1. to compare the incidence of skin mucosal inflammation in chronic nephritis and common people 2. in view of the causal relationship between skin mucosal inflammation and IgA nephropathy in the literature. We use IgA nephropathy as a model to study the reasons for the high incidence of inflammation of skin and mucous membrane in the population of IgA nephropathy, and to explore the reasons for repeated occurrence and the reasons for the recurrence. The possible prevention and control strategy.3. compared the incidence of skin and mucous inflammation in the group of patients with different pathological types of chronic nephritis, find out the various clinical indexes of different pathological types, and make preliminary exploration for the use of clinical phenotypes to predict the type of kidney pathology. 4. in the past, the previous study found that a type of syndrome can contain a variety of physique, We further explored the methods of influencing the clinicopathological characteristics of chronic nephritis: 1. a case-control study was conducted to collect data from 85 cases of nephritic isolated microscopic hematuria and 85 cases of common people, and to compare the incidence of skin mucosal inflammation in chronic glomerulonephritis with common people in.2. epidemiology. The method of field investigation was used to collect 162 cases of skin mucosa inflammation, inflammatory causes and TCM Constitution of patients with IgA nephropathy, to study the causes of high incidence of inflammation of skin and mucous membrane in people of IgA nephropathy, to analyze the relationship between the constitution of the skin and mucous membrane, the causes of inflammation, and to explore the possible countermeasures for the prevention and treatment of.3., and collect 226 methods of epidemiological investigation. Cases of skin mucosa inflammation, clinical features, TCM Constitution and TCM syndrome types of chronic nephritis patients with pathological type of renal biopsy, compared with different pathological types of chronic nephritis in the group of patients with chronic nephritis, and find out the different clinical indexes of different pathological types and.4. research methods and investigation. In the third part, the clinical data of 104 cases of spleen and kidney qi deficiency type IgA nephropathy were collected and 102 cases of different constitution of membranous nephropathy were collected. The effects of constitution and syndrome on the renal clinicopathological effects were analyzed. Results: 1. the incidence of chronic nephritis and common people's skin and mucous membrane inflammation was compared with the kidney source. There was no difference in baseline data between the cases of sexual isolated hematuria and the control group, and the comparison of skin and mucosa inflammation showed that the incidence of inflammation in the skin and mucous membrane in the hematuria group was higher than that of the control group. The more types of inflammation were more, the more significant the two groups were. Oral ulcers, oral ulcers more than 2 times / years, chronic pharyngitis, chronic tonsillitis, chronic rhinitis, reflux esophagitis, and chronic dermatosis, there are statistically significant differences in two groups. The more episodes of acute inflammation, such as colds and oral ulcers, the more statistically significant the two groups are. The repeated or chronic inflammation of the skin and mucous membrane is in the chronic kidney The incidence of inflammatory groups is very high? What are the factors associated with the occurrence of inflammation in the skin and mucous membrane? What is the relationship with the occurrence and development of renal diseases? Investigation of 2.IgA nephropathy and related factors in 2.1162 cases of IgA nephropathy, the general analysis of 92 cases in 162 patients and 70 cases in women, with an average age of 35.9 + 12 .5 years old, the average course of disease was 42.9 + 35.5 months, among which 19 cases (11.7%) were caused by nephrotic syndrome, 25 cases (15.4%) with naked eye hematuria, 150 cases (92.6%) and 162 cases of.2.2 in 162 patients, and 162 cases of IgA nephropathy were distributed in 162 cases, 78 cases (48.1%), Qi deficiency 23 cases (14.2%), Yang deficiency syndrome cases There were three types of concurrently, 7 cases of qi depression, 7 cases of qi depression (4.3%), 15 cases of special quality (9.3%), and 6 cases of blood stasis (3.7%).2.3 IgA nephropathy in patients with recurrent or chronic inflammation of the skin and mucous membrane, of which there were 141 cases (87%), 21 cases (13%) without inflammation, chronic rhinitis, chronic pharyngitis and chronic pharyngitis. 28 cases (17.3%) of sexual tonsillitis, 68 cases of gingivitis or periodontitis, 28 cases of repeated oral ulcers (17.3%), 43 cases of recurrent upper respiratory tract infection (26.5%), 35 cases of chronic enteritis (21.6%), chronic gastritis or duodenal ulcer 31 (19.1%), skin inflammation (urticaria or acne) 71 cases (43.8%). A patient can have many kinds of inflammation and inflammation of the skin and mucous membrane. The distribution of the causes of 2-3 kinds of.2.4 inflammation in the skin and mucous membrane, we investigated the causes of repeated or chronic inflammation of the skin and mucous membrane, mainly 70 cases of climate change (43.2%), 37 cases of dietary factors (22.8%), 44 cases of insomnia (27.2%), 48 cases of fatigue (29.6%), 11 cases (6.8%) of emotional factors and 19 cases (11.7%) of allergic factors (11.7%), constitution and inflammation of Chinese medicine. Compared with the physique of traditional Chinese medicine, the types of the 9 types of inflammation were compared with the physique of traditional Chinese medicine. The incidence of gastritis or duodenal ulcers and yin deficiency is high and has statistical significance. Compared with the quality of peace and quality, the incidence of repeated or chronic skin inflammation is high, and there is a statistical significance (P0.05) the comparison between the constitution of.2.6 and the inducement of inflammation in the comparison of the physical and inflammatory inducements, we also found that the distribution of the constitution under the causes of different mucosal inflammation is also found. Differences, such as the causes of climate change induced inflammation, have a higher proportion of asthenia and yang deficiency patients, compared with the flat and phlegm and phlegm dampness. The patients with dietary factors inducing or aggravating the skin and mucous membrane inflammation are more humid and yin deficiency, compared with the flat and yang deficiency. Patients with phlegm dampness are most significant (P0.05). The incidence of skin mucosal inflammation is very high in patients with IgA nephropathy, which is related to the physique of traditional Chinese medicine. Then how is the disease in other pathological types of chronic nephritis? Can the physique be used to pretest the different pathological types of chronic glomerulonephritis? 3. different diseases The comparison of skin mucosal inflammation and clinical phenotypes in 3.1226 patients with chronic nephritis and clinical phenotypes in 226 cases, the age of 226 patients was mostly between 18 and 55 years, 133 men, 93 women, 38 (12,48) months in the course of disease, 1 (0.4%), 136 cases (60.2%), MN There were 15 cases (6.6%) in the group of IgA (IgA+MN), 61 cases (27%) in MN, 13 (5.8%) in group MCD and 226 of.3.2 in 226 patients. Among the 226 patients, there were 3 cases of lack of TCM Constitution and syndrome type, and 223 patients were analyzed statistically. The distribution of TCM syndrome type was spleen kidney qi deficiency 152 (68.2%) and spleen and kidney. There were 48 cases (21.5%) of Yang deficiency, 32 cases of water wet syndrome (14.3%), 48 cases of damp turbid syndrome (21.5%), 58 cases of damp heat syndrome (26%), 32 cases of blood stasis syndrome (14.3%). The most common in the constitution of traditional Chinese medicine were Ping and Qi (35.4%), followed by qi deficiency and substance 29 cases (26%), phlegm and wet quality cases of.3.3 skin mucosa inflammation to chronic nephritis The number of FSGS cases was less than that of pathological type, so it was not included. The results showed that chronic rhinitis, chronic pharyngitis, recurrent or chronic gingivitis / periodontitis had a statistically significant difference in the different pathological distribution of skin acne (P0.05). 22 after comparison, repeated or chronic gingivitis / periodontitis was mostly in IgA+MN, MN patients, and compared with IgAN. Statistical significance, the proportion of IgA+MN was higher than that of MCD.IgAN upper respiratory tract inflammation and skin inflammation, and compared with MN (P0.05) the comparison of clinical parameters of different pathological types of.3.4 chronic nephritis listed 20 kinds of statistically significant indexes, including age, medical history, clinical indicators, TCM Constitution and syndrome type, and further 22 comparison after comparison. It was found that IgAN age, the proportion of nephrotic syndrome, the proportion of renal function abnormalities, 24 hours urinary protein, albumin, serum creatinine and other three groups were statistically significant (P0.01), the age of MCD patients was lower than MN (P0.01), the serum IgA, C3 in group MN were lower than group IgAN, IgE was higher than that of IgAN group, and the results were statistically significant (P0.01), and in constitution and syndrome type, spleen and kidney yang The proportion of deficiency syndrome and yang deficiency was higher than that in group IgAN (P0.01), and the proportion of phlegm wet quality in IgAN was higher than that in group MN (P0.01). In this study, the distribution of TCM Constitution and syndrome type between different pathological types of nephritis was found to be different, we also found that sometimes a type of syndrome can contain a variety of body. Quality, and will it affect the clinical pathology of kidney? 4. Chinese medicine constitution, syndrome type and clinicopathological study of chronic nephritis 4.1 comparison of the clinicopathological characteristics of different constitution of spleen and kidney qi type IgA nephropathy: 4.1.1 three types of kidney pathology Katafuchi integral and clinical indexes, we have included 104 cases of spleen and kidney Qi deficiency patients, Chinese medicine body There were three types of physique, 40 cases of flat and qualitative, 19 cases of qi deficiency and 45 cases of damp heat (including damp heat and phlegm wet quality). The integral of qi deficiency glomeruli was lower than that of flat and mass. The integral of the renal blood vessel was higher than that of flat and mass. The difference was statistically significant. The integral and total score of the glomeruli were the lowest in the Qi deficiency, followed by the mass and the highest humid quality. Trends. Total cholesterol, triglycerides, creatinine and uric acid were the lowest, followed by the flat and mass, the highest tendency of the wet quality, the clinicopathological comparison of the different constitution of.4.2 membranous nephropathy compared 4.2.1 baseline and pathological comparison in 102 cases of membranous nephropathy, the main syndromes of TCM were spleen kidney qi deficiency (64.2%) and spleen kidney yang deficiency 30 cases (28.3%), lung (28.3%), lung Kidney qi deficiency in 1 cases (0.9%), Qi and yin deficiency in 2 cases (1.9%), yin and yang two deficiency 1 cases (0.9%) were not included in the comparison. No special temperament, qi stagnation and blood stasis, phlegm wet quality and damp heat are all the damp constitution, because the number of wet and damp heat in the phlegm and damp heat are all the damp constitution. There were 43 cases (42.2%), 11 cases of qi deficiency (10.8%), 14 cases of humid mass (13.7%), 24 cases of Yang deficiency (23.5%) and 6 cases of non Yang deficiency (5.9%). There were no statistical significance in the age, course of illness, and distribution of hypertension in these five constitution. There were statistical significance in the sex distribution of the patients in the five group. Middle level and mass, Yang deficiency quality is the lowest, Qi deficiency, non Yang deficiency is the second, the humid quality is the highest, the difference has statistical significance. The proportion of stage II membranous nephropathy in patients with spleen and kidney qi deficiency damp type patients is higher than that of other physical types, followed by flat and spleen kidney qi deficiency type, Qi deficiency spleen and kidney qi deficiency type is the smallest, the difference has statistical significance.4.2.2 five kinds of constitution. The results of the laboratory examination compared with the renal function, the creatinine was higher than the Qi deficiency and the Yang deficiency.24 hourly proteinuria, with the highest moisture content. The blood creatinine and the 24 hour urine protein had the lowest Qi deficiency, the level and the quality were the highest. The comparison of the Yang Deficiency clinical disease theory was not less than the non Yang deficiency. Conclusion: 1. skin sticky The incidence of membrane inflammation is higher in patients with nephritic hematuria. There are no colds, cold more than 3 times per year, chronic pharyngitis, tonsillitis and rhinitis, oral ulcers, oral ulcers more than 2 times / years, reflux esophagitis, and high incidence of chronic dermatosis in the nephritic hematuria group, with high incidence of inflammation of skin and mucous membrane in.2.IgA nephropathy patients.3.IgA Kidney disease is likely to be a major disease spectrum from its own inflammatory disease to autoimmune disease.4. constitution related to the type of inflammation of the skin and mucous membrane, especially Qi deficiency, Yang deficiency and upper respiratory tract inflammation, yin deficiency and chronic gastritis, damp heat and repeated or chronic skin inflammation, related to the cause of inflammation, especially Qi deficiency. The factors of Yang deficiency and climate change, damp heat, yin deficiency and diet, phlegm, humidity and hypersensitivity, which can guide the individualized prevention of the interaction between.6. constitution and environmental factors may be an important basis for the production of IgA nephropathy,.7. of different pathological types of chronic glomerulonephritis with different.8. four types of pathological types There are many other indicators (including clinical and laboratory indicators, TCM Constitution and TCM syndromes)..9. can combine these indicators.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：博士
【學位授予年份】：2016
【分類號】：R692

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