Clinical Observation Of Modified Shenqi Dihuang Decoctiong In The Treatment Of Idiopathic Membranous Nephropathy With Deficiency Of Spleen And Kidney,dampness,Turbidity And Biood Stasis

Objective: To observe the clinical efficacy of modified Shenqi Dihuang Decoction Combined with tacrolimus in the treatment of idiopathic membranous nephropathy with deficiency of spleen and kidney,dampness,turbidity and blood stasis,and to explore the feasibility of integrated traditional Chinese and Western medicine in the treatment of idiopathic membranous nephropathy,in order to promote its clinical application.Materials and methods: the outpatient and ward electronic medical record system was used to collect 60 patients who were treated in the outpatient and ward of the third Department of kidney of Heilongjiang College of traditional Chinese medicine from September 2019 to December 2021.The pathological diagnosis of renal biopsy was idiopathic membranous nephropathy,and met the deficiency of spleen and kidney,dampness,turbidity and blood stasis type of traditional Chinese medicine.According to the diagnostic criteria,inclusion criteria and exclusion criteria,they were randomly divided into two groups.One group was the control group and the other group was the treatment group.A total of 30 cases in the control group were treated with basic Western medicine and tacrolimus;A total of 30 cases in the treatment group were treated with modified Shenqi Dihuang Decoction on the basis of the control group.The course of treatment was 6 months.Observe the clinical symptoms and signs of the two groups before and after treatment,and statistically analyze the laboratory indexes(24-hour urinary protein,serum albumin,triglyceride,cholesterol,blood creatinine,urea nitrogen,blood glucose,D-dimer,serum anti pla2 r antibody),TCM symptom score,safety index and tacrolimus blood concentration before and after treatment,so as to evaluate the effect of modified Shenqi Dihuang Decoction on deficiency of spleen and kidney Clinical efficacy and safety of idiopathic membranous nephropathy with dampness,turbidity and blood stasis.Result:1.Clinical efficacy analysis: the quantitative urinary protein,serum albumin,triglyceride,cholesterol,serum creatinine,urea nitrogen,blood glucose,D-dimer and serum anti pla2 r antibody of the two groups were improved compared with those before treatment,and the curative effect of the treatment group was better than that of the control group.3.Total score of TCM syndrome: the symptoms and signs of the two groups after treatment were better than those before treatment,the total score of TCM syndrome was lower than that before treatment,and the effect of the treatment group was significantly better than that of the control group.4.Analysis of curative effect of TCM syndrome: in the treatment group,3 cases were cured,14 cases were markedly effective,10 cases were effective and 3 cases were ineffective.The total effective rate in the treatment group was 90.00%;In the control group,2 cases were cured,11 cases were markedly effective,7 cases were effective and10 cases were ineffective.The total effective rate of the control group was 66.67%.It shows that the TCM Syndromes of the two groups are improved after treatment,and the curative effect of the treatment group is better than that of the control group.5.Safety analysis: there were no abnormal changes of liver function,renal function and ECG in both groups during the treatment.The blood routine examination of the two groups before and after treatment was also normal,indicating that the treatment methods of the two groups were safe.Conclusion:1.Modified Shenqi Dihuang Decoction can significantly improve the clinical symptoms and signs of idiopathic membranous nephropathy patients with deficiency of spleen and kidney,dampness,turbidity and blood stasis.2.Modified Shenqi Dihuang Decoction can reduce urinary protein,increase serum albumin,reduce blood lipid level,improve renal function,improve hypercoagulable state,reduce pla2 r antibody level,delay disease progression and improve clinical efficacy in patients with idiopathic membranous nephropathy of deficiency of spleen and kidney,dampness,turbidity and blood stasis.3.The modified Shenqi Dihuang decoction has no abnormal liver function and renal function.It has good safety and can be further popularized in clinical practice.