| IgA nephropathy is a primary glomerular disease mediated by immune complex,which is characterized by mesangial IgA deposition and mesangial cell proliferation.30-40%of patients will develop end-stage renal disease(ESRD)after 20-30 years of diagnosis.IgA nephropathy accounts for about 45.3%of primary glomerular diseases in China.In clinic,IgA nephropathy patients often have tubulointerstitial injury.It was reported that the degree of tubulointerstitial injury is positively correlated with the risk of progression to the end event,which is an independent risk factor of disease progression.At present,there is no special treatment for tubulointerstitial injury of IgA nephropathy,mainly around reducing proteinuria and symptomatic support treatment to delay the progress of kidney disease.In this study,on the basis of normal treatment,we used a randomized controlled double-blind method to observe the protective effect of modified Huangqi Chifeng Decoction on renal tubulointerstitium of IgA nephropathy.ObjectiveTo observe the protective effect and safety of modified Huangqi Chifeng Decoction on renal tubulointerstitium in patients with IgA nephropathy.Methods60 patients with IgA nephropathy in the outpatient department of Nephrology,Xiyuan Hospital,Chinese Academy of traditional Chinese medicine from 2018 to 2020 who met the inclusion criteria and signed the informed consent were randomly divided into the experimental group(30 cases)and the control group(30 cases)using randomized controlled double-blind method.The control group was treated with telmisartan and conventional western medicine,and the experimental group was treated with modified Huangqi Chifeng Decoction on the basis of the control group.The treatment cycle was 24 weeks.The general information,TCM syndrome score,urinary ACR,urinary NAG,urinary α1-MG,urinary β2-MG,urinary RBP and urinary MMP-7 were recorded.And the estimated glomerular filtration rate,liver function and blood routine were also observed and recorded.Finally,the test results were statistically analyzed.Results①General information:A total of 8 patients with abscission failed to follow up on time for some reason,including 5 cases of abscission in the experimental group and 25 cases of effective cases.In the control group,3 cases fell off,and 27 cases were effective.The experimental group included 12 female patients and 13 male patients.The control group included 14 female patients and 13 male patients.There were no significant differences in age,BMI,hypertension,disease duration,urea nitrogen,uric acid and albumin between the experimental group and the control group(P>0.05),which mean the two groups were comparable.②TCM syndrome scores:Compared with before treatment,the TCM syndrome scores of the experimental group and the control group both decreased significantly after treatment(P<0.01).The total effective rate was 84%in the experimental group and 51%in the control group,and the difference was statistically significant(P<0.05).③Urinary ACR:After treatment,the urinary ACR in the experimental group decreased significantly(P<0.05),the urinary ACR also decreased significantly in the control group(P<0.05).The decrease in the experimental group was more significant than that in the control group,and significant difference was seen between the two groups(P<0.05).④Urinary NAG,urinary α1-MG,urinary β2-MG,urinary RBP:In the experimental group,the urinary NAG and urinary al-MG decreased significantly after treatment and the difference was statistically significant(P<0.05)while the control group had no significant difference after treatment(P>0.05).But there was no significant difference between two groups in the urinary NAG and urinary αl-MG after treatment(P>0.05).Compared with before treatment,there was no significant difference in the urinary RBP and urinary β2-MG in both the experimental group and the control group after treatment(P>0.05).⑤Urinary MMP-7:After treatment,the urinary MMP-7 in the experimental group decreased significantly and the difference was statistically significant(P<0.05)while the difference in the control group was not statistically significant(P>0.05).And there was no statistical difference in urinary MMP-7 between the two groups after treatment(P>0.05).⑥eGFR and safety indexes:There was no significant difference in eGFR in the experimental group and the control group(P>0.05),the renal function in these two groups were stable.Also,there was no significant difference in liver function and blood routine in two groups(P>0.05),and no adverse events occurred during the treatment process.ConclusionThe modified Huangqi Chifeng decoction can effectively relieve the symptoms of IgA nephropathy patients,reduce proteinuria and has a protective effect on the tubulointerstitium of IgA nephropathy.Furthermore,it is safe to use without adverse reactions.The protective mechanism may be related to regulating the expression of MMP-7. |
PDF Full Text Request