A Retrospective Cohort Study Of Huang Chunlin In The Treatment Of Refractory Nephrotic Syndrome

Objective:Through a retrospective case-analysis cohort study of Professor Huang Chunlin in the treatment of refractory nephrotic syndrome(RNS),the clinical efficacy and safety of Professor Huang Chunlin in the treatment of RNS were evaluated.The aim was to seek effective and safe treatment for patients with refractory nephrotic syndrome,and the problems in the retrospective cohort study were analyzed and the corresponding countermeasures were put forward.To provide suggestions for future prospective studies.Method:A retrospective cohort study was conducted to analyze the clinical data of patients with refractory nephrotic syndrome diagnosed in Huang Chunlin Clinic of Guangdong Traditional Chinese Medicine Hospital from January 1,2008 to January 1,2018.74 patients were successfully followed up.The follow-up results were inputted into the database and analyzed by statistical software.Huang Chunlin’ s treatment was evaluated in terms of total remission rate and recurrence rate.The efficacy and safety of refractory nephrotic syndrome were discussed,and the problems in the cohort study were discussed,and the corresponding countermeasures were put forward.Result:After screening for inclusion and exclusion criteria,74 patients were included,including 26 in TCM group and 48 in integrated traditional Chinese and Western medicine group.There was no statistical significance in gender,age,course of disease and pathological type of each group.Total effective rate and recurrence rate:6 months after treatment,the total remission rate of TCM group was 96.2%.The total effective rate was 85.4%in the integrated Chinese and Western medicine group,and there was no significant difference between the two groups(P>0.05).There was no significant difference in remission rate between the two groups(P>0.05).The recurrence rate in one year was 15.4%in TCM group and 12.5%in integrated Chinese and Western medicine group.There was no significant difference between the two groups(P>0.05).Quantitative analysis of 24-hour urinary protein:There was no significant difference in 24-hour urinary protein between the two groups before and after treatment(P>0.05);the median of each estimated time point was 3.82 before treatment,0.92 after 6 months of treatment and 0.41 after 12 months of treatment,while the 24-hour urinary protein between the two groups after treatment(6 months of treatment and 12 months of treatment)was compared with that before treatment(P>0.05).There were significant differences before treatment(P<0.01),but there was no significant difference between 6 months of treatment and 12 months of treatment(P>0.05).Serum creatinine:There was no significant difference between the two groups before and after treatment(P>0.05);within the group,the median estimated at each time point was 74.00 before treatment,74.00 after 6 months of treatment and 68.00 after 12 months of treatment.There was no significant difference between the two time points after treatment(6 months of treatment and 12 months of treatment)and before treatment(P>0.05).Albumin:There was no significant difference between the two groups before and after treatment(P>0.05);the median of each time point was 28.10 before treatment,33.25 after 6 months treatment,34.80 after 12 months treatment,and there was significant difference between the two time points after treatment(6 months after treatment,12 months after treatment)and before treatment(P<0.01).There was no significant difference between 6 months and 12 months(P>0.05).Total cholesterol:There was no significant difference between the two groups before and after treatment(P>0.05);the median of each time point was 8.18 before treatment,6.62 after 6 months of treatment and 6.01 after 12 months of treatment.There was significant difference between the two time points after treatment(6 months after treatment and 12 months after treatment)compared with before treatment(P<0.01).The difference between 6 months and 12 months was significant(P<0.001).TCM syndrome score:there was no significant difference between the two groups before and after treatment(P>0.05);the median of each time point was 25.00 before treatment,15.00 after 6 months of treatment and 15.00 after 12 months of treatment.There were significant differences between the two groups at 2 time points(6 months,12 months)after treatment and before treatment(P<0.01),and there were significant differences in the scores of TCM syndromes between 6 months and 12 months after treatment(P<0.001).Adverse reactions:After 12 months of treatment,the incidence of adverse events was 23.07%in the TCM group and 22.92%in the integrated Chinese and Western medicine group,with no statistical difference(P>0.05).Conclusion:Huang Chunlin’s TCM experience group and Huang Chunlin’s TCM experience based on the use of hormone/immunosuppressant combined with traditional Chinese and Western medicine group can significantly reduce 24-hour urinary protein quantification,total cholesterol,increase plasma albumin,improve clinical symptoms of patients.After half a year’s treatment,the Chinese medicine group and the Western medicine group can achieve a higher remission rate.The recurrence rate in one year is low,the renal function is stable,and there are fewer adverse reactions.There is no significant difference in the efficacy and remission rate between the two groups.