Reinforcing Spleen And Kidney And Clearing Heat And Activating Blood-based Treatment Of Idiopathic Membranous Nephropathy Clinical Observation

Objective: Membranous nephropathy is a common immune-mediated glomerular disease characterized by the presence of immune deposits on the epithelial side of the glomerular capillary wall and diffuse thickening of glomerular basement membrane.Currently the pathogeny of Idiopathic Membranous Nephropathy is not clear.The clinical features of IMN is nephrotic syndrome.The primary treatment of western medicine includes nonspecific treatment and specific treatment which includes glucocorticoid and immune inhibitor.But after long terms use of glucocorticoid and immune inhibitor,side effects and adverse reactions were observed in some patients.In our study,reinforcing spleen and kidney and clearing heat and activating blood-based traditional Chinese combined with glucocorticoid and cyclophosphamide were used to cure Idiopathic Membranous Nephropathy.TP,ALB,CHOL,TG,24h-UTP,BUN,CREA,UA,TCM syndrome scorings were observed to evaluate the clinical curative effect and the security of integrative traditional Chinese and western medicine.Methods: In the study,there were 50 IMN patients who were volunteered and collected from the patients of inpatient and outpatient in Hebei Province Chinese Medicine Hospital and the Third Hospital of Hebei Medical University.All patients were randomly divided into two groups:twenty-five cases in the test group and the other twenty-five cases in the control group.Patients were monitored for 6 months.The control group was treated with glucocorticoid,cyclophosphamide and some symptomatic treatments.The test group was treated with reinforcing spleen and kidney and clearing heat and activating blood-based traditional Chinese medicine based on the treatment of the control group for 6 months.Compare the change of TP,ALB,CHOL,TG,24h-UTP,BUN,CREA,UA,TCM syndrome scorings,blood test,liver function and ECG before and after the treatment and compute the total efficiency rate to judge curative effect and incidence of side effects.Results:Before treatment,there was no statistical difference in the TCM syndrome total scorings,TCM syndrome scorings,TP,ALB,CHOL,TG,24h-UTP between two groups(P>0.05)and the two groups were comparable.1 Comparison of the clinical efficacy: The total effective rate of the test group was 88%.And the total efficiency of the control group was 60.9%.The total effective rate of two groups were significant difference(P<0.05).2 Comparison of TCM syndrome scorings: Compared with that before treatment,the TCM syndrome total scorings of two groups were significantly decreased after the test(P < 0.01).After treatment,the total scoring of test group was significantly lower than the control group(P <0.01).And some TCM syndrome scorings of test group lower than the control group(P<0.05).3 Comparison of TP,ALB: Compared with that before treatment,the TP,ALB of two groups were increased significantly after three or six months of treatment(P<0.01),After three or six months of treatment,TP,ALB of test group were better than the control group(P<0.05,P<0.01).4 Comparison of 24h-UTP: Compared with that before treatment,the24h-UTP of two groups were decreased significantly after three or six months of treatment(P<0.01).After three or six months of treatment,24h-UTP of test group were lower than the control group(P<0.05,P<0.01).5 Comparison of CHOL,TG: Compared with that before treatment,the CHOL,TG of two groups were decreased after six months of treatment(test group: P < 0.01,control group: P < 0.05),After six months of treatment,CHOL,TG of test group were lower than the control group(P<0.05).6 Comparison of kidney function: Before and after treatment,BUN,CREA and UA were normal in the test group and the control group.7 Comparison of the side effects: 5 patients had side effects and side effects appeared 6 times in the test group.And 11 patients had side effects andside effects appeared 15 times in the control group.The test group had less side effects than the control group.Conclusions:Compared with simple western therapy,Integrative traditional Chinese and western medicine therapy on Idiopathic Membranous Nephropathy can obviously reduce 24h-UTP and blood fat,increase total protein and albumin,improve major clinical symptoms,improve clinical curative effect and reduce the incidence of side effects caused by glucocorticoid and cyclophosphamide.Integrative traditional Chinese and western medicine has high clinic value and deserves further study.