1.Study on Syndrome Development Rules before and after Treating Primary Nephrotic Syndrome with Hormone
Jun WANG ; Xu DENG ; Meichang XU
Journal of Zhejiang Chinese Medical University 2016;40(9):669-676
Objective]Based on 346 cases of PNS patients using glucocorticoids observed during treatment, the main symptoms, syndrome differentiation of syndrome type of traditional Chinese medicine(TCM) by induction, and discusses its the evolution regularity of TCM Syndromes.[Methods]Develop a unified observation table, then clinicians recorded symptoms, signs, tongue picture and type of pulse to log on to observe truthfully and un-mistakbly table, after the end of observation, comprehensive analysis by the four examination methods, using a unified standards for TCM syndrome type determination. Discussion after glucocorticoids treatment of patients with PNS TCM syndrome objective laws of evolution.[Result]First ,TCM syndrome evolution:the results show that:before hormone treatment, Qi deficiency of spleen and kidney and Yang deficiency of spleen and kidney have become the most important type of syndrome;hormone use initial stages 1~4 weeks, Qi deficiency of spleen and kidney, deficiency of Qi and Yin, when the hormone used for 5~8 weeks. Yin deficiency of liver and kidney and deficiency of Qi and Yin occupied the main position; during the hormone withdrawal stage, the deficiency of Qi and Yin increased significantly; in the hormone maintain stage it was mostly deficiency of Yin and Yang and Yang deficiency of spleen and kidney. As for demonstration, in hormone therapy before a lot of patients suffering from retention of water and turbid damp;After the treatment of 1~4 weeks it was mostly humid heat ,turbid damp and blood stasis;the accompanying symptoms were mostly humid heat, blood stasis and pathogenic factor of wind after the treatment of 5-8 weeks ;Miscellaneous accompanying symptoms were very conspicuous except retention of water in the treatment of hormone withdrawal stage; In the hormone maintaining stage, the highest proportion of blood stasis compared with others. The use of hormone therapy, humid heat and blood stasis were more prominent than others. Second, after the hormone treatment(1~8weeks) the relationship between efficacy and TCM syndromes: A total of 130 patients enrolled, the 96 patients with Yin deficiency syndrome, the rest of the patients had no deficiency of Yin syndrome. The results indicated that Yin deficiency syndrome group serum albumin and 24-hour urinary protein excretion efficacy than those without Yin deficiency syndrome group, with statistical significance.[Conclusion] Glucocorticoids should belong to pure Yang medicine in traditional Chinese medicine, the body under the action of pure Yang drugs are prone to Yin deficiency symptoms, suggests that the higher the sensitivity to drugs, the clinical remission rate is also higher. This can be applied in clinical glucocorticoids and observe the change of the patients with syndrome, early in the patients' sensitivity to the glucocorticoids.