| Objective: To observe the clinical efficacy and safety of Huoxue Lishui recipe on idiopathic membranous nephropathy with yang deficiency and blood stasis syndrome and the effect of anti-PLA2 R antibody in peripheral serum.Methods: In a single center cohort study,50 patients with idiopathic membranous nephropathy who met the inclusion criteria in the Department of Nephrology of Liuzhou traditional Chinese Medicine Hospital from January 2020 to June 2021 were randomly divided into experimental group(n = 25)and control group(n = 25).The experimental group was treated with Huoxue Lishui decoction for 6 months.The levels of 24h-UTP,Alb,anti-PLA2 R,FIB,D-Dimer,TG,CHO,safety index(WBC,Scr,ALT,AST),western medicine curative effect index and TCM syndrome score of the two groups before and after treatment were statistically analyzed with SPSS 26.0.to evaluate and compare the clinical efficacy and safety of Huoxue Lishui recipe combined with western medicine and western medicine alone.Results: 1.Evaluation of the efficacy of western medicine: after treatment,the total effective rate(88% vs 76%)and markedly effective rate(80% vs 48%)in the experimental group were higher than those in the control group(P < 0.05).Evaluation of TCM efficacy: after treatment,the total effective rate(88% vs 28%)and markedly effective rate(28% vs12%)in the experimental group were higher than those in the control group(P < 0.001),and the difference was statistically significant.2.Laboratory index evaluation.2.1 24h-UTP:the level of 24h-UTP in the experimental group and the control group after treatment was significantly lower than that in the control group(P < 0.001).The level of 24h-UTP in the experimental group was lower than that in the control group after treatment,and the difference was statistically significant.2.2 Alb:the level of Alb in both groups after treatment was higher than that before treatment(P < 0.001),and the Alb in the experimental group was significantly higher than that in the control group 6 months after treatment(P < 0.001).2.3 anti-PLA2R:the level of anti-PLA2 R in both groups after treatment was lower than that before treatment(P < 0.001),and the level of anti-PLA2 R in the experimental group was lower than that in the control group 6 months after treatment,and the difference was statistically significant(P < 0.001).2.4 FIB:the level of FIB in both groups after treatment was lower than that before treatment(P < 0.001),and the level of FIB in the experimental group was significantly lower than that in the control group6 months after treatment(P < 0.001).2.5 D-Dimer:the level of D-Dimer in both groups after treatment was lower than that before treatment(P < 0.001),and the level of D-Dimer in the experimental group was significantly lower than that in the control group 6 months after treatment(P < 0.001).2.6 TG:the level of TG in both groups after treatment was lower than that before treatment(P < 0.001),and the level of TG in the experimental group was significantly lower than that in the control group 6 months after treatment(P < 0.001).2.7 CHO:the level of CHO in both groups after treatment was lower than that before treatment(P < 0.001),and the level of CHO in the experimental group was significantly lower than that in the control group6 months after treatment(P < 0.001).2.8 TCM score: the TCM score level of both groups after treatment was lower than that before treatment(P < 0.001),and the TCM score level of the experimental group was lower than that of the control group 6months after treatment,the difference was statistically significant(P <0.001).3.Safety evaluation.3.1 ALT:there was no significant difference in the level of ALT between the two groups before and after treatment,and there was no significant difference in ALT between the two groups 6 months after treatment.3.2 AST: there was no significant difference in AST between the two groups before and after treatment,and there was no significant difference in AST between the two groups 6 months after treatment.3.3 Scr:the Scr in the control group 6 months after treatment was higher than that before treatment,and there was no significant difference in the experimental group before and after treatment.The Scr in the treatment group increased with the extension of treatment time,but had no effect on the experimental group,and there was no significant difference in Scr between the two groups 6 months after treatment.3.4 WBC: there was no significant difference in the level of WBC between the two groups before and after treatment,and there was no significant difference in the level of WBC between the two groups 6months after treatment.4、Evaluation of adverse events.Adverse reactions: digestive tract reaction: 2 cases in the experimental group,5 cases in the treatment group;urinary reaction: 1case in the treatment group,except digestive tract reaction and urinary tract reaction,there were no other adverse reactions in the two groups.after symptomatic treatment,the symptoms of the patients with adverse reactions in the two groups disappeared and did not affect the normal treatment.Conclusion(s): the combined therapy of traditional Chinese and western medicine based on Huoxue Lishui recipe can improve the hypercoagulable state,reduce the risk of thrombosis and protect renal function in patients with idiopathic membranous nephropathy by reducing24-hour urinary protein,increasing the level of serum albumin and anti-PLA2 R,reducing fibrinogen,D-dimer,triglyceride and total cholesterol,and can significantly improve the clinical symptoms of patients with yang deficiency and blood stasis syndrome.The adverse reactions are relatively few,which is worthy of clinical promotion. |
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