Efficacy Of Zhuang Medicine Compound Xiancao Granule In The Treatment Of IgA Nephropathy And Its Effect On The Level Of Inflammatory Factors And Podocyte Excretion

Objective:To observe the efficacy and safety of Zhuang medicine compound Xiancao granule in the treatment of Ig AN,and explore the efficacy of Zhuang medicine compound Xiancao granule on levels of IL-6,TNF-α,TGF-β₁ in blood with urine and urinary PCX.Combined with the observation of curative effect and laboratory biological index,to explore the possible mechanism of compound Xiancao granule in the treatment of Ig AN,to provide a new scheme for Ig AN’s clinical treatment,and to provide more clinical basis for the promotion and application of compound Xiancao granule.Methods:84 Ig AN patients with deficiency of both Qi and Yin combined with damp-heat and blood stasis syndrome were randomly divided into control group（n=42）and treatment group（n=42）.Patients in both groups were given basic treatment such as health education,diet control,diuresis and detumescence.On the basis of these treatments,the control group was treated with valsartan tablets,and the treatment group was treated with compound Xiancao granule on the basis of the treatment in the control group.Both groups were treated for 8 weeks.The clinical efficacy,TCM syndrome score,urine red blood cell count（URBC）,24 hour urinary total protein（24h-UTP）,urine microalbumin creatinine ratio（ACR）,urinary total protein/urinary creatinine ratio（UTP/UCREA）,serum creatinine（Scr）,blood and urine IL-6,TNF-α,TGF-β₁,urine PCX levels and safety indexes were compared between the two groups before and after the treatment.Results:（1）During the observation period,among 42 cases in the control group,3cases were shedding,there were 39 patients completed this clinical observation;42 cases in the treatment group,2 cases were shedding,and 40patients completed this clinical observation.（2）Clinical efficacy:After treatment,the effective rate of the treatment group was 87.50%,which was significantly higher than that of the control group（74.36%）（P<0.05）.（3）Reduction of TCM syndrome scores:After treatment,the TCM syndrome scores of the two groups were lower than before,and the scores of the treatment group were significantly lower than those of the control group,and the differences were statistically significant（P<0.05）.（4）The change of URBC:After treatment,the level of URBC in the two groups was lower than before,and the decrease in the treatment group was significantly better than which in the control group,and the difference was statistically significant（P<0.05）.（5）Changes of urinary protein excretion:After treatment,the levels of24h-UTP,ACR and UTP/UCREA in the two groups were lower than those before the treatment,and the levels of 24h-UTP,ACR and UTP/UCREA in the treatment group were lower than those in the control group,and the difference was statistically significant（P<0.05）.（6）Improvement of renal function:After treatment,the level of Scr in the two groups was lower than that in the control group,and the level of Scr in the treatment group was significantly lower than that in the control group（P<0.05）.（7）Changes of inflammatory factors:After treatment,the levels of IL-6,TNF-αand TGF-β₁ in blood and urine of the two groups were significantly lower than those before treatment,and the level of decrease in the treatment group was significantly lower than that in the control group（P<0.05）.（8）The change of podocyte excretion level:After treatment,the urine PCX level in both groups was lower than that in this group,and the decrease level in the treatment group was lower than that in the control group,and the difference was statistically significant（P<0.05）.（9）Safety indicator observation:The blood routine,liver and kidney function,stool routine and other safety indexes of the two groups were not abnormal before and after treatment,and no serious adverse reactions occurred during the 8 weeks of treatment.Conclusion:（1）In the treatment of Ig AN patients with deficiency of both Qi and Yin combined with damp-heat and blood stasis syndrome,Zhuang medicine compound Xiancao granule can significantly reduce the excretion of URBC and urinary protein,down-regulate the levels of IL-6,TNF-α,TGF-β₁ in blood and urine,and PCX in urine,reduce inflammatory reaction,reduce the destruction and excretion of podocytes,and then improve renal function.（2）Zhuang medicine compound Xiancao granule has a good clinical effect in treating Ig AN patients with deficiency of both Qi and Yin combined with damp-heat and blood stasis syndrome,and significantly improves the TCM syndrome of patients,and improves the quality of life of Ig AN patients with deficiency of both Qi and Yin combined with damp-heat and blood stasis syndrome.（3）Zhuang medicine compound Xiancao granule combined with valsartan tablet is more effective and safe in the treatment of Ig AN than valsartan tablet alone.