Classification of TCM syndromes of IgA nephropathy: factor analysis and clustering analysis
2014, 37 (2):
Objective To investigate the classification methods of TCM syndromes of primary IgA nephropathy and syndrome affiliation of micro-manifestations by using clinical and epidemiological survey, and provide some evidences for differentiation of syndromes of IgA nephropathy combining macroscopic and microscopic information. Methods The data related to information of four examinations in TCM, physical examinations, laboratory examinations and renal pathology were collected from the multicenter patients with IgA nephropathy (n=354), and a database was built. A study on nonlinear dimension reduction of TCM syndromes was conducted to analyze the macroscopic and microscopic information of 69 factors by using methods of factor analysis and clustering analysis. Results A total of 19 common factors were extracted and 5 TCM syndrome types of IgA nephropathy were summed up, including spleen-kidney yang deficiency combined with blood stagnation syndrome, spleen qi deficiency combined with phlegm dampness syndrome, liver-kidney yin deficiency, lung qi deficiency combined with wind-heat syndrome, and qi-yin deficiency combined with dampness-heat syndrome. The micro-manifestations, such as glomerular filtration rate (GFR, 15-29 mL/min), renal tubular atrophy or renal interstitial fibrosis (T2), interstitial inflammatory infiltration (>50%), were more common in spleen-kidney yang deficiency combined with blood stagnation syndrome, urine protein (≥3.5 g/d), decrease of blood albumin and increase of blood cholesterol were found mostly in spleen qi deficiency combined with phlegm dampness syndrome, higher blood pressure, urine protein (0.2 -3.5 g/d, GFR (30%-89%), renal tubular atrophy or renal interstitial fibrosis (T1), crescents fiber, inflammatory infiltration (25%-50%), ball hardening and small arterial wall thickness were common in liver-kidney yin deficiency syndrome, and urine occult blood level (≥+++), mesangial cell hyperplasia (M1), segmental glomerular sclerosis or adhesions (S1), capillary fiber hyperplasia (E1), crescent cells and crescent fiber cells were mostly seen in qi-yin deficiency combined with dampness heat syndrome. Conclusion It is helpful for classification study on TCM syndromes of IgA nephropathy by using factor analysis and clustering analysis. Meanwhile, it will provide reference of objective and microcosmic basis for diagnosis of IgA nephropathy combined with macroscopic and microscopic information.
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