Clinical Study Of Qingre Huashi Decoction In The Treatment Of Damp Heat Accumulation Type Of Idiopathic Membranous Nephropathy

Objective: To observe the clinical efficacy and safety of Qingre Huashi Decoction in the treatment of patients with damp heat accumulation type of idiopathic membranous nephropathy(IMN),so as to provide clinical practice basis for the intervention of traditional Chinese medicine in IMN.Methods: Patients who met the inclusion criteria of IMN damp heat accumulation type in the outpatient and ward of Nephrology Department of the Affiliated Hospital of Shandong University of traditional Chinese medicine were randomly divided into experimental group and control group.Both groups were treated with western medicine support treatment and calcineurin inhibitor(CNI).The control group was treated with Huangkui capsule(5capsules each time,3 times a day),and the experimental group was treated with Qingre Huashi Decoction(one dose a day,taken separately in the morning and evening)for 6 months.The quantitative urinary protein,serum albumin,triglyceride,total cholesterol,anti phospholipase A2 receptor antibody,serum creatinine,urea nitrogen,TCM syndrome score and safety indexes of the two groups before and 24 hours after treatment were detected,and the relevant data were statistically analyzed.Results:(1)In this study,a total of 64 patients completed the trial,with 32 cases in the experimental group and 32 cases in the control group.Before treatment,there was no significant difference in the basic data,laboratory examination indexes and TCM symptom scores between the two groups(P>0.05).(2)After treatment,the total effective rate of Western medicine in the experimental group was 84.38%,higher than 75% in the control group(P<0.05).(3)After treatment,the TCM syndrome scores of the two groups were lower than before,especially in the experimental group(P<0.01);The total effective rate of TCM symptoms in the experimental group was 87.5% and 71.88%in the control group,which was higher than that in the control group(P< 0.05).(4)After 6 months of treatment,24-hour urinary protein,triglyceride,total cholesterol and serum anti phospholipase A2 receptor antibody levels in the two groups were significantly lower than those before treatment,and serum albumin was significantly higher(P<0.01);The experimental group was better than the control group in reducing 24-hour urinary protein,triglyceride,total cholesterol,serum anti phospholipase A2 receptor antibody and increasing serum albumin(P<0.05).After treatment,serum creatinine and urea nitrogen in the experimental group decreased(P<0.05),while there was no significant change in the control group before and after treatment(P>0.05);There was significant difference in serum creatinine level between the two groups(P<0.05),and there was no significant difference in urea nitrogen(P>0.05).Conclusion: Qingre Huashi Decoction Combined with CNI can improve the clinical comprehensive curative effect,significantly improve the clinical symptoms,reduce proteinuria,improve the level of serum albumin,improve dyslipidemia and maintain the stability of renal function.It is worthy of clinical application.