Clinical Observation On The Treatment Of Idiopathic Membranous Nephropathy With Qi-Yin Deficiency And Dampness-heat By The Method Of Benefiting Qi,Tonifying The Kidneys And Clearing The Diaphragm

OBJECTIVE: To treat patients with idiopathic membranous nephropathy(IMN)with Qi-Yin deficiency and Damp-Heat type by using the formula of Yi-Qi tonifying the kidney and Qing-Li,and to evaluate the efficacy of this formula to provide an effective formula for the diagnosis and treatment of this disease.METHODS: 80 patients with qi-yin deficiency and damp-heat type IMN with positive anti-PLA2 R antibody were selected from Qingdao Traditional Chinese Medicine Hospital and randomly divided into two groups using a randomized controlled trial method: according to the method of randomized controlled trial,80 cases were randomly divided into observation group and control group with 40 cases in each group.All patients were given conventional treatment and immunosuppressive treatment,and the observation group was given Yi Qi and Kidney Qing Li granules orally on this basis.Before and after the treatment,the patients in the two groups were treated with Chinese medicine evidence score table,and the laboratory indexes of serum albumin(ALB),24 h urine protein quantification(24h-UTP),serum PLA2 R antibody,urea nitrogen(BUN),blood creatinine(SCr),endogenous creatinine clearance(Ccr),cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL-C).The correlation between serum PLA2 R antibody and serum ALB,24h-UTP before treatment was analyzed for all 80 patients;the laboratory indexes serum ALB,24h-UTP,serum PLA2 R antibody,BUN,SCr,Ccr,TC,TG,LDL-C before and after treatment were compared between the two groups,and the efficacy of Chinese medicine evidence and clinical efficacy were performed according to the relevant efficacy evaluation criteria evaluation.Results:1.Correlation between serum PLA2 R antibody and serum ALB and 24h-UTP:80 patients showed negative correlation between serum PLA2 R antibody and serum ALB(r=-0.251,P <0.05)and positive correlation with 24-UTP(r=0.412,P<0.05)before treatment.2.Laboratory indices.(1)24h-UTP and serum ALB: the 24h-UTP level after treatment in the observation group was significantly lower than that before treatment(P<0.01),and better than that in the control group(P<0.05).The serum albumin level after treatment was significantly higher than that before treatment(P<0.01),and better than that in the control group(P<0.05).(2)Serum PLA2 R antibody: serum PLA2 R antibody level after treatment in the observation group decreased significantly compared with that before treatment(P < 0.01),and better than that in the control group(P < 0.05).(3)TC,TG and LDL-C: TC,TG and LDL-C level after treatment in the observation group decreased significantly compared with those before treatment(P < 0.01),and better than that in the control group(P < 0.05).3.Chinese medical evidence efficacy: The Chinese medical evidence efficacy rate in observation group and control group was 82.50% and 60.00%,respectively,and there was a significant difference between the two groups(P < 0.05).4.The total efficiency of clinical efficacy: the total efficiency of clinical efficacy of the observation group was 77.50%,and the total efficiency of clinical efficacy of the control group was 57.50%,and there was a significant difference between the two groups(P < 0.05).Conclusion: Yiqi tonifying kidney clearing formula can effectively reduce urinary protein,increase serum albumin,improve lipid metabolism,reduce serum anti-PLA2 R antibody level,improve TCM clinical symptoms,and improve patients’ quality of life in treating patients with IMN of Qi-Yin deficiency and Damp-Heat type,and is an effective formula for treating this disease.