Retrospective Study Of Membranous Nephropathy Cipher Prescription Combined With Western Medicine In The Treatment Of Idiopathic Membranous Nephropathy

Objective: To use membranous nephropathy（MN）cipher prescription combined with Western medicine in the treatment of adult idiopathic membranous nephropathy（IMN）,and to collect the TCM syndromes and efficacy indicators for statistical analysis.To evaluate the efficacy and advantages of MN cipher prescription combined with Western medicine in the treatment of IMN,and to provide TCM treatment ideas for better improving the clinical symptoms and clinical efficacy of IMN patientsMethods:1.Data source:Inpatient and outpatient IMN patients meeting inclusion and exclusion criteria were collected from November 2018 to November 2021 in the Department of Nephrology,Optics Valley Hospital of Hubei Provincial Hospital of Traditional Chinese Medicine.Basic data and laboratory indicators of the cases were collected.2.Total of 117 cases were collected and divided into groups according to clinical treatment plan.Patients who only received the basic support therapy and immunosuppressive therapy during the course of observation were the control group,and patients who were treated with MN cipher prescription on the basis of treatment plan of the control group were the treatment group.3.Observation Targets: Four weeks were used as a treatment course,and six consecutive treatment courses were observed.The changes of outcome measures included the basic data,24 hour urine protein quantification,M-type Phospholipase A2 receptor Antibody（PLA2R-Ab）titer,serum creatinine,urea,uric acid,hemoglobin,C-reactive protein,erythrocyte sedimentation rate,serum total protein,serum albumin,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,fibrinogen,D-Dimer,B lymphocyte CD19+,Th/Ts,edema degree,TCM syndrome score,TCM syndrome efficacy,disease total efficacy and safety index analysis.4.Data processing and analysis:the collected data were imported into IBM SPSS Statistics 25.0,and the corresponding P-value was obtained according to the statistical results.P≥0.05 indicated no statistical significance and no significant difference.P<0.05 indicates statistical significance and significant difference.Results:1.The male to female ratio of the patients included in this study was 3.18:1,and their ages ranged from 18 to 81 years old,and84.62% of the cases were over 45 years old.2.Analysis of efficacy indicators:before treatment,there was no significant difference in laboratory indicators between the two groups（P>0.05）.After treatment,there was significant difference in the negative rate of anti-PLA2R-Ab in the treatment group（P<0.05）,but no significant difference in the control group（P>0.05）,and no significant difference in the titer reduction rate of anti-PLA2R-Ab in the two groups compared with before treatment（P>0.05）.However,there were significant differences in anti-PLA2R-Ab negative rate and anti-PLA2R-Ab titer drop rate between the treatment group and the control group（P<0.05）..There were significant differences in the decrease of CHOL,Fbg,and increase of ALB and STP in the two groups compared with before treatment（P<0.05）,but the improvement of these indicators appeared earlier in the treatment group（after 3 months of treatment,there was significant difference between the two groups,P<0.05）.There was significant difference in ESR reduction in the treatment group compared with before treatment（P<0.05）,but no significant difference in the control group（P>0.05）,and significant difference between the two groups（P<0.05）.There were no significant differences in Scr,BUN,UA,CRP,D-Dimer,Hb,TG,HDL,LDLBCD19+ and Th/Ts in the two groups（P>0.05）,and no significant differences between the two groups（P>0.05）.3.Comparison of clinical symptoms :（1）Comparison of edema regression:the total effective rate of the treatment group was84.88%,and the total effective rate of the control group was64.52%.There was significant difference between the two groups（P<0.05）.（2）Comparison of TCM syndrome score: the TCM syndrome score of the treatment group was 5.71±2.61,and that of the control group was 6.39±3.40.There was significant difference between the two groups compared with before treatment（P<0.05）,but no significant difference between the two groups（P>0.05）.4.Analysis of TCM syndrome efficacy: the total effective rate of the treatment group and the control group was 91.86% and 61.29%respectively,and there was significant difference between the two groups（P<0.05）.5.Analysis of total curative effect: the total effective rate was 66.28% in the treatment group and 41.94% in the control group,and there was significant difference between the two groups（P<0.05）.6.Safety indicators: 117 patients included in this study had stable vital signs before and after treatment,and no significant abnormal changes in blood biochemical safety indicators（ALT,AST and serum potassium）during the treatment.Conclusion:The treatment of IMN patients with MN cipher prescription combined with Western medicine can significantly increase the negative conversion rate of anti-PLA2R-Ab,reduce the titer level of anti-PLA2R-Ab,reduce urinary protein,increase the level of ALB and STP,reduce the level of ESR,CHOL and Fbg.Significantly reduce edema and other clinical symptoms of patients,promote the remission of the disease faster,and enhance the therapeutic effect.