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Journal of Traditional Chinese Medicine >

2025 , Vol. 45 >Issue 1: 167 - 175

DOI: https://doi.org/10.19852/j.cnki.jtcm.2025.01.016

Study on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy based on expert consensus

  • Dan WANG ,
  • Xiaoyan HUANG ,
  • Ping LI ,
  • Xiaofan HONG ,
  • Yumin ZHANG ,
  • Rongrong WANG ,
  • Kun BAO ,
  • Xing LIANG
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  • 1 Nephrology Department, Qianxinan Autonomous Prefecture Hospital of Traditional Chinese Medicine, Xingyi 562400, China
    2 Nephrology Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
    3 State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
    4 Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Disease, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
    5 Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou 510120, China

Received date: 2023-12-11

  Accepted date: 2024-05-15

  Online published: 2025-01-10

Supported by

the Special Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine: Study on Criteria for Diagnosis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Cohort Study on Pathogenesis and Material Basis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Randomized Controlled Clinical Study of Sanqi Qushi Granule in Treatment of Membranous Nephropathy(SZ2021ZZ02);the Special Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine: Study on Criteria for Diagnosis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Cohort Study on Pathogenesis and Material Basis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Randomized Controlled Clinical Study of Sanqi Qushi Granule in Treatment of Membranous Nephropathy(SZ2021ZZ09);the Special Project of State Key Laboratory of Dampness Syndrome of Chinese Medicine: Study on Criteria for Diagnosis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Cohort Study on Pathogenesis and Material Basis of Dampness Syndrome of Idiopathic Membranous Nephropathy, Randomized Controlled Clinical Study of Sanqi Qushi Granule in Treatment of Membranous Nephropathy(SZ2021ZZ36);the 2020 Guangdong Provincial Science and Technology Innovation Strategy Special Fund: Guangdong-Hong Kong-Macau Joint Lab(2020B1212030006);the Natural Science Foundation of Guangdong Province: Study on the Mechanism of Sanqi Qushi Prescription Delaying Podocellular Senescence in Membranous Nephropathy based on Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase-Stimulator of Interferon Genes-Nuclear Factor Kappa-B Signaling Pathway(2022A1515011628);the Guangzhou Science and Technology Plan Project: to Explore the Mechanism of Treating Membranous Nephropathy from the Perspective of Regulating Amino Acid Metabolism Disorder(2023A03J0746);Special Funding for Scientific and Technological Research on Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine: a Multimodular Machine Learning Prediction Model based on Pathological Image-transcriptomics and Traditional Chinese Medicine Syndromes was Used to Investigate the Prognostic Correlation of Long non-coding RNA Molecules in Nephropathy and the Intervention Mechanism of Sanqi Qushi Formula, to Investigate the Pathogenesis and Microbiological Mechanism of Dampness Syndrome of Membranous Nephropathy based on the Microecological Changes of Tongue Coating(YN2023MB02);Special Funding for Scientific and Technological Research on Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine: a Multimodular Machine Learning Prediction Model based on Pathological Image-transcriptomics and Traditional Chinese Medicine Syndromes was Used to Investigate the Prognostic Correlation of Long non-coding RNA Molecules in Nephropathy and the Intervention Mechanism of Sanqi Qushi Formula, to Investigate the Pathogenesis and Microbiological Mechanism of Dampness Syndrome of Membranous Nephropathy based on the Microecological Changes of Tongue Coating(YN2023MB10)

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Abstract

OBJECTIVE: To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy (IMN) patients by literature research and expert investigation (interviews and a Delphi method).

METHODS: Our study was consistent with T/CACM 1336-2020. We searched the monographs and references published in the past 40 years (1983-2022), and established the diagnostic criteria pool of water-dampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine (TCM) based on literature by using frequency statistics and correlation analysis. Expert investigation (interview method and two rounds of Delphi method) was used to form the diagnostic criteria of water-dampness syndrome and dampness-turbidity syndrome of idiopathic membranous nephropathy. Clinical diagnostic test research was carried out, and compared with “Diagnostic Criteria for dampness syndrome” (T/CACM 1454-2023) to evaluate the authenticity, reliability and clinical application value of the standard.

RESULTS: A total of 122 relevant guides, standards, monographs and documents were included through searching books and Chinese databases. Four experts were interviewed and two rounds of delphi method (75 experts nationwide) were carried out. The experts' opinions are relatively concentrated and the differences are small. Based on the weight of each index, the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected. After discussion by the core group members, the diagnostic model of "necessary symptoms and optional symptoms" was established, and the final diagnostic criteria of water-dampness syndrome and dampness-turbidity syndrome were established. One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study. There was no statistical difference in gender, age and course of disease (P > 0.05). The sensitivity and specificity of the trial standard were 90.34% and 73.33% respectively, while the sensitivity and specificity of T/CACM 1454-2023 were 99.43% and 6.67%, respectively.

CONCLUSIONS: The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.

Key words： glomerulonephritis, membranous; diagnostic tests, routine; syndrome of dampness obstruction; combination of disease and syndrome; syndrome diagnostic criteria

Cite this article

Dan WANG , Xiaoyan HUANG , Ping LI , Xiaofan HONG , Yumin ZHANG , Rongrong WANG , Kun BAO , Xing LIANG . Study on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy based on expert consensus[J]. Journal of Traditional Chinese Medicine, 2025 , 45(1) : 167 -175 . DOI: 10.19852/j.cnki.jtcm.2025.01.016

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