Efficacy Of Yiqi Qingre Decoction Combined With Immunomodulation In The Treatment Of IgA Nephropathy In High Risk

The immunoglobulin A (IgA) nephropathy (IgAN) is represented by a proliferation of glomerular mesangial cells jointed with the presence of IgA deposition in the mesangial area. Its estimated frequency is at least 2.5 cases per year per 100,000 adults. Genome-wide association studies have shed important insight into the reasons underlying the disparate worldwide distribution of IgAN, with its very high prevalence in East Asia. High risk patients show a rapid decrease in the GFR that may be associated with nephritic syndrome or crescentic glomerulonephritis. These findings may be already present at IgAN diagnosis or may develop during the disease evolution. There is no consensus on the treatment of high risk IgA nephropathy. Based on clinical, by the retrospectively analyze, the study is to observe the effect of the combined therapy-Yi Qi Qing Jie Prescription combined with immunosuppressive therapy.Research purpose:Based on clinical, by the retrospectively analysis, the study is to observe the effect of the combined therapy of high risk IgA nephropathy-Yi Qi Qing Jie Prescription combined with immunosuppressive therapy.Mainly observed these index-changes of Sar、eGFR、UTP、 ALb, incidence of clinical endpoints, rate of renal survival, changes of TCM syndrome, aiming to provide support of clinical data.Research methods:Patients were conformed the standard diagnostic of high risk IgA nephropathy and treated with Yi Qi Qing Jie Prescription combined with immunosuppressive therapy in Guang’anmenHospital,ChinaAcademyofChineseMedicalSciences before the January of 2016. By the retrospectively analysis and observed over 6 months, the study collected and analyzed clinical data of patients. Mainly observed these index-changes of Scr、eGFR、UTP、ALb, incidence of clinical endpoints, rate of renal survival, changes of TCM syndrome.The results:1 Curative effection:38 patients were treated after 6 months, no clinical recovery,3 obviously improved,17 improved,16 stable,2 invalid, ended with 94.7% total effective rate. Total TCM symptom scores decreased respectively, P<0.01.2 Clinical data:after 6 months’treatment, the data of SCr, ALb, UTP and eGFR have been improved respectively, P<0.01. The ofUA has been improved, P<0.05. The average data of BUN has been improved, with no statistical significance, P>0.05.3 Clinical endpoints:Till the end of our follow-up,1 patient doubled in SCr,1 arrived ESRD. There were 2 patients arrived the united endpoint (5.26%). The rate of renal survival is 94.7%.4 Complication:1 impaired glucose tolerance, no seriously infect.Conclusion:1 The treatment showed a short-term improvement.2 The treatment may relieve clinical symptoms, reduce the complication.