作　　者： (王芝芩）; (李亚妤）;

机构地区： 浙江省桐庐县第一人民医院,311500

出　　处： 《浙江临床医学》 2017年第10期1907-1909,共3页

摘　　要： 目的探寻抗中性粒细胞胞浆抗体（ANCA）相关性小血管炎（AASV）肾损害中医证型与肾脏病理的相关性，丰富中医辨证分型的客观依据。方法采用回顾性分析的研究方法，选取45例具有肾活检病理资料的AASV肾损害住院病例，根据中医证候兼夹情况分组研究。结果中医证型调查结果显示：虚证存在于所有病例中，但未发现单纯虚证存在者，多兼夹浊瘀证，其次为风湿证。各中医证型组间，肾小球硬化程度及纤维性新月体比例均值依虚＋风湿证、虚＋浊瘀＋风湿证、虚＋浊瘀证组递增，而细胞性新月体比例均值依虚＋风湿证、虚＋浊瘀＋风湿证、虚＋浊瘀证组递减。各中医证型组的BvAs积分由高至低依次为：虚＋风湿证、虚＋风湿＋浊瘀证、虚＋浊瘀证。结论通过比较AASV肾损害中医各组肾脏病理指标及BVAS积分推测：虚证代表疾病慢性化基础，风湿证代表疾病相对急性活动性病变，而浊瘀证代表疾病相对慢性化痛变。 Objective To explore the correlation between TCM syndrome type and renal pathology of ANCA associated small vessel vasculitis （ AASV ） , and enrich the objective basis of TCM dialectical type. Methods A retrospective analysis was used to study the AASV renal damage in 45 cases with renal biopsy. Results The results of traditional Chinese medicine （ TCM ） investigation showed that： deficiency syndrome existed in all cases, but there was no simple deficiency syndrome, and more and more turbid blood stasis syndrome.the TCM syndrome type groups, the degree ofglomerular sclerosis and fibrous crescents mean proportion according to deficiency syndrome and deficiency of rheumatism ＋ ＋ ＋ phlegm stasis rheumatism syndrome and deficiency ＋ blood stasis group and increasing turbidity, cellular crescents mean proportion according to deficiency syndrome and deficiency of rheumatism ＋ ＋ ＋ phlegm stasis syndrome and deficiency ＋ rheumatism phlegm stasis syndrome group.the TCM syndrome types of BVAS points from high to low followed by： virtual ＋ rheumatism, deficiency ＋ rheumatism ＋ turbidity stasis, deficiency and turbid blood stasis syndrome, Conclusions Through the comparison of the AASV renal damage TCM kidney are pathological index and BVAS score that represents the deficiency of chronic diseases, rheumatic disease relative activity of the certificate on behalf of acute lesions, while the turbid stasis disease represents relative chronic lesions.

关 键 词： 相关性小血管炎肾损害 中医辨证分型 肾脏病理