Objective: To observe the clinical efficacy and safety of Jianpi Wenshen and Qufeng Shengshi formula in the treatment of idiopathic membranous nephropathy of spleen kidney yang deficiency and rheumatic internal disturbance,and to provide new ideas and new basis for the treatment of idiopathic membranous nephropathy with traditional Chinese medicine.Methods: A total of 86 patients with stage I and II idiopathic membranous nephropathy(spleen and kidney yang deficiency and rheumatic internal disturbancetype)with nephrotic syndrome were randomly divided into two groups,there were 43 case in the control group and 43 cases in the observation group.The two groups were all given basic treatment,the control group was given the modified Ponticelli regimen,the observation group was treated with Jianpi Wenshen and Qufeng Shengshi formula on the basis of treatment in the control group.The treatment cycle of both groups was 6months.The TCM syndrome score,24-hour urinary protein(24-UTP),serum albumin(ALB),blood lipid(CHOL,TG),renal function(Scr,e GFR),liver function(AST,ALT)were observed before and after 3,6 months of treatment and the total remission rate and adverse reactions were observed before and after treatment,to analyze and evaluate the clinical efficacy and safety of Jianpi Wenshen and Qufeng Shengshi formula in the treatment of idiopathic membranous nephropathy.Results: A total of 86 patients were included in this study,including 6patients who dropped out midway,Finally,there were 40 cases in the control group and 40 cases in the observation group.There was no significant difference in general data and laboratory indexes between the two groups before treatment(P > 0.05),there is comparability between the two groups.1.Comparison of TCM syndrome score: the TCM syndrome score of the two groups decreased significantly(P<0.05)compared with that before treatment(P<0.05),the improvement of TCM syndrome score of the observation group was better than that of the control group(P<0.05).2.Comparison of the total remission rate of Western medicine: The total remission rate of the observation group and the control group was 80% and67.5% respectively,and the observation group was better than the control group.the difference was statistically significant(P<0.05).3.Comparison of 24h-UTP,ALB,TG and CHOL: After 3 and 6 months of treatment,the 24h-UTP,TG and CHOL in both groups decreased significantly as compared with those before treatment(P<0.05),the ALB of the two groups decreased significantly as compared with that before treatment(P<0.05),After 3 and 6 months of treatment,the observation group was superior to the control group in reducing 24-hour-utp,increasing ALB and regulating blood lipid(P<0.05).4.Comparison of ALT,AST,Scr and e GFR: After 3 and 6 months of treatment,there was no significant difference in ALT,AST,Scr and e GFR between the two groups as compared with those before treatment(P>0.05),There was no significant difference in ALT,AST,Scr and e GFR between the two groups(P>0.05).5.Comparison of the incidence of adverse reactions between the two groups: the incidence of adverse reactions in the observation group and the control group was 20% and 32.5% respectively,and there was no significant difference between the two groups(P>0.05).Conclusions: The therapeutic effect of Jianpi Wenshen and Qufeng Shengshi formula combined with modified Ponticelli scheme on idiopathic membranous nephropathy of spleen kidney yang deficiency and rheumatic internal disturbance type is better than that of modified Ponticelli scheme alone,which can significantly improve the clinical symptoms of patients,reduce the syndrome score of traditional Chinese medicine,24-hour urine protein,total cholesterol,triglyceride,improve serum albumin,and it is safe and reliable,worthy of promotion. |