| BackgroundThe Systemic lupus erythematosus(SLE) is an autoimmune connective tissue diseases witch can damage The Multiple-organ and multisystem. Llupus nephritis (LN) is the main complications and the leading cause of death in SLE. So, controling the development of lupus nephritis disease is an important means to determine the prognosis of SLE.With the advent of new immunodepressant, the therapy programs to Combined glucocorticoid with new immunosuppressive is to promote, although these programs significantly improve the clinical efficacy of LN, but there are also have some problem such as the significant side effects, hormonal resistance, hormone dependent and we can't continue the medical treatment because of the bad compliance, ect. So, Traditional Chinese Medicine and integrative medicine treatment has become one of the most important research in LN in recent years. Looking at the literature reports in these years, most of the researchers think that the integrative medicine is better than the western medicine in LN's teatment.But now researchers have deffent views about the type of syndrome and the corresponding syndrome medication, and there is not have the recognized best treatment of integrative medicine at the present time.ObjectivesThrough the observation statistics of the clinical symptoms, lupus activity score and laboratory examination before and after the six's treatment, to knowing the clinical effectiveness and safety of combining traditional Chinese and western medicine treatment with lupus nephritis and discussing the significance of integration treatment in LN, provides the clinical diagnosis and treatment evidence for it.MethodsWe collected 39 lupus nephritis patients in ours hospital(The Chinese hospital in guangdong province) by the way of the method of itself comparison, If the patients'state of an illness were severe activity, we gave them glucocorticoid(1mg/(kg·d)), and then decreased 10 persent every month after 6-8 week, and add the CTX 0.8g/month Intravenous drip at the same time. If they were in gentle or medium activity, we gave them glucocorticoid 0.4-0.6 mg/(kg·d).We added the one of the immunodepressants such asAzathioprine (100mg qd),Leflunomide (10mg qd),Tacrolimus (1mg q12h) or Mycophenolate mofetil (0.75g bid)。We offered dialectical Chinese treatment (according to the unified Chinese symptomes and treatment). A course of treament was 3 month, we treated 2 course, then watched the clinical symptoms, lupus activity score and laboratory examination after 6 month。Result(1) The frequency analysis of the preliminary findings showed that there had 7 (17.9%) male and 32 (82.1%) female in the 39 patients, the minimum Age was 17, the maximum age was 62, the mean age was 25.6±11.11. There were 25 cases who did the renal biopsy, which contained 1 (4%) case of typeⅡ,3 (12%) cases of type 111,15(60%) cases of type IV,4 (16%) cases of type V,2(8%) cases of typeⅣ+Ⅴ.The more common type of syndrome in inactive phase is the Qi and Yin Deficiency 16(41%), and the Spleen and Kidney Qi Deficiency13 (33.3%). There has no significant correlation between the TCM type of syndrome and pathological type (p>0.05).(2) Through the score of SLEDIA, we calculated that there had 14 (35.9%) gentle active cases,15 (38.5%) medium active cases and 10 (25.6%) severe active cases. After the teatment, there had 9 (23.16%) gentle active cases,21 (53.8%) medium active cases and no severe active cases. there had significant differences (P<0.05). Before the integrative medicine, clinical symptoms are manifested by 22 (56.4%) mild cases,15 (38.5%) moderate cases and 2 (5.1%) severe cases. After the treament, all of the moderate and severe cases turned to light disease, the aggregate score less than before, there had significant differences (P<0.05).(3) After the treatment, laboratory teests such as the 24 hour total urinary protein,ESR, ALB, C3, CH50 were improved over the previous, the anti-ds-DNA' s negative rate was more than before, and the positive rate of this antibody is closely related to disease activity, all of these were significant different(P<0.05) (4) We compared the patients'safety index such as renal function, liver function and blood counting before and after the treatment,the result showed that there had no change in the course of treatment, there had no significant correlation, that meand there had no adverse reaction after treatment.(5) By the way of the treatment on the combination of TCM with Western in Lupus Nephritis patients, there were 14cases (35.9%) in completeremission, partial remission was the second, (22 cases, coverde 56.4%), there wer 3 patients (7.7%) were certifide ineffective,total effective rate was 92.3%.ConclusionThe treatment on the combination of TCM with Western medicine in LN can effectively improve the clinical symptoms, which could accelerate treament from the period of remission induction into maintainable remission; which could reduced uric protein and ESR. Though compared with itself before and after, The Study on the Exploratory of The treatment on the combination of TCM with Western medicine in Lupus Nephritis can still achieve a satisfactory effect. |
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