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目的分析儿童足细胞病中医证型与临床特点及实验室检查的关系。方法收集我院儿科2008年3月—2011年3月经肾穿刺活检明确肾脏病理的76例足细胞病住院患儿,在肾穿刺活检前24 h内进行中医辨证分型,分析各证型临床和实验室检查结果。结果 76例患儿中,肺脾气虚型21例,脾虚湿困型13例,脾肾阳虚型24例,肝肾阴虚型7例,气阴两虚型11例。其中肺脾气虚型患儿66.7%存在前驱感染,气阴两虚型患儿72.7%无前驱感染;肺脾气虚型患儿病程小于2个月者占71.4%,气阴两虚型患儿病程大于2个月者占81.8%;患儿血清清蛋白肺脾气虚型最高,气阴两虚型最低;血脂指标肺脾气虚型最低,气阴两虚型最高;尿蛋白定量和尿N-乙酰-B-D-氨基葡萄糖苷酶(NAG酶)均以脾肾阳虚型患儿最高,肺脾气虚型最低。结论儿童足细胞病中医证型与有无前驱感染和病程存在相关性;不同证型的血清学、尿液实验室检查指标存在差异。
Objective To analyze the relationship between TCM syndromes, clinical features and laboratory tests in children with podocytopathy. Methods A total of 76 pediatric patients with podocytic disease who were confirmed by renal biopsy in our pediatric department from March 2008 to March 2011 were enrolled in this study. Within 24 hours before the biopsy of kidney, TCM syndrome differentiation was performed. Laboratory test results. Results Among the 76 children, 21 cases were pulmonary spleen and qi deficiency, 13 cases were wet and spleen deficiency syndrome, 24 cases were deficiency of spleen and kidney, 7 cases were liver and kidney yin deficiency and 11 cases were deficiency of qi and yin. Among them, 66.7% of children with spleen qi deficiency had pre-infection, 72.7% of children with deficiency of qi and yin had no prodromal infection, 71.4% of children with pulmonary spleen qi deficiency had less than 2 months duration, Patients with more than 2 months accounted for 81.8%. Serum albumin in children had the highest spleen-qi deficiency type, the lowest qi-yin deficiency type, the lowest serum-spleen-qi deficiency type, and the highest qi-yin-deficiency type. -BD-glucosaminidase (NAG enzyme) were the highest in spleen and kidney yang deficiency type, the lowest spleen qi deficiency type. Conclusion There is a correlation between the syndromes of TCM and the presence of prodromal infection and course of disease in children with podocytic disease. There are differences in laboratory and laboratory indexes of serodiagnosis and urine in different syndromes.