Clinical Study On The Treatment Of Refractory Nephrotic Syndrome By Regulating The Spleen And The Stomach

Objective: Refractory nephrotic syndrome(RNS)is a special and more common types of nephrotic syndrome(NS),it is refers to the adequate process(general 8 to 12 weeks)after hormone treatment but has not alleviate the condition of nephrotic syndrome.Clinical express of it is characteristics are massive proteinuria(more than 3.5g/d),hypoproteinemia(less than 30g/L),hyperlipidemia and severe edema.With the further understanding of the disease and the development of modern medicine,although the treatment of the disease will continue to have the emergence of new drugs,but the treatment of refractory nephrotic syndrome is still a difficult problem in clinical,lingering and refractory,hormone dependence are bring patients great suffering.Patients with poor disease control,often has kidney damage with time prolonging.Traditional Chinese medicine will be the disease attributed to the category of "edema" and "turbid urine",in TCM classics early record of this disease,Professor Yang Hongjuan adhering to the classics of Chinese medicine based on the classic Yellow Emperor’s of internal medicine and febrile and miscellaneous diseases.The treatment of this disease combined with Chinese and Western medicine.In the treatment of Western medicine and emphasizes TCM to spleen and stomach,in the clinical treatment of syndrome differentiation and treatment,which acquired the solid,Qi and blood biochemical active.And the treatment of patients with RNs made good effect.In this study,Professor Yang HongJuan dialectical theory treatment based on strict screening cases into groups with the principles of randomized controlled trials,experimental observation in accordance through compared to the rate of patients in 24 hours urine protein,plasma albumin,kidney function,blood lipids and clinical symptoms mitigation.And analysis and evaluat of curative effect to verify method of regulating spleen and stomach in patients with RNS,and provide preliminary data and to pave the way.Methods:This study was originated from the RNS patients in the first hospital of Hebei Medical University in the department of Professor Yang Hongjuan,from October,2012 to June,2015.According to the inclusion and exclusion criteria,60 patients were randomly divided into control group and treatment group with 30 cases in each group.The control group was used treatment of glucocorticoids combined with cyclophosphamide.The treatment group was on the basis of the control group and then the doctor of traditional Chinese medicine syndrome differentiation typing to spleen and stomach principle combined with traditional Chinese medicine decoction oral treatment.Medication was observed after 6 months of two groups of patients in 24 hours urine protein,plasma albumin,renal function,blood lipids and clinical symptoms.And to analyzed curative effect from the spleen and stomach to treat refractory nephropathy syndrome.Results:1 Two groups before and after the treatment of 24 hours urinary protein quantitative changeCompared to the control group and treatment group and the group before treatment,two cases of 24 hours urinary protein were significantly decreased before and after treatment(P<0.05).Compared the treatment and control group,24 hour urinary protein significantly reduced after treatment in treatment group(P<0.05).2 Changes of plasma albumin in the two groups before and after treatmentCompared to before and after treatment,the two groups of cases albumin levels were significantly increased(P<0.05).After treatment in treatment group,plasma albumin levels increased with significant difference(P<0.05).3 Changes of kidney function before and after treatment in two groupsCompare before and after the treatment,urea nitrogen and blood urea nitrogen(BUN),blood creatinine(serum creatinine SCR)changes in the level of no significant difference(P>0.05).Treatment group and the treatment group compare BUN levels decreased significantly(P<0.05)and SCR levels has no significant difference(P>0.05).After treatment,the treatment group BUN levels decreased significantly(P<0.05)and SCR levels no significant difference(P>0.05)compared with the control treatment group.4 Comparison of the lipid level between the treatment and control groupIn the tow group,cholesterol(total cholesterol,TC)levels were decreased significantly compared after the treatment(P<0.05),triglyceride(TG)levels were not significantly different(P>0.05).The levels of TC and TG were significantly decreased in treatment group(P<0.05).Compared with the control treatment group,TG levels were significantly decreased in the treatment group after treatment,TC level no significant difference(P>0.05).5 Changes of main symptoms and signs of the two groups before and after treatmentAfter treatment in the control group and the treatment group,patients symptoms were obviously improved.Compared with the control group,treatment group in improving anorexia,abdominal distension,Yaoxisuanruan,fatigue was significantly better than the control group(P<0.05).In the treatment of edema,diarrhea group no statistical difference(P>0.05).6 Comparison of clinical efficacy(total effective rate)After statistical analysis,the control group of 30 patients in complete remission for 6 people,obviously relieved in 8,partial remission 9,invalid 7,control group the total efficiency was 76.67%,30 cases of patients in treatment group with complete remission 8 people,relieve the 10 people,partial remission 9,invalid 3,treatment group total efficiency was 90%;after statistics processing,two groups of total efficiency was statistically significant(P<0.05).Tip: the treatment group in the treatment of refractory nephrotic syndrome is better than simple western medicine treatment.Conclusion:1 Chinese medicine through the study of TCM differentiation on the treatment,to "regulating spleen and stomach" Dafa,We can significantly reduce the refractory nephrotic syndrome patients with 24 hour urinary protein,increase the serum albumin level and reduce blood urea nitrogen,protect kidney function,lower triglyceride levels,and improve the patient’s clinical symptoms combined with western medicine.2 Through the two groups of comparative study,combined with western medicine on the basis of the spleen and stomach,take the combination of disease and differentiation of individual treatment,can significantly improve the efficiency of treatment.