| ObjectiveReview and analyze the clinical data of idiopathic membranous nephropathy from Traditional Chinese Medicine Hospital of Guangdong Province and General hospital of Guangzhou Military Region. Research the clinical efficacy of Chinese medicine intervention treatment for idiopathic membranous nephropathy. Provide the effective scheme for treating idiopathic membranous nephropathy.MethodAccording to inclusion criteria, clinical data of 283 hospitalized patients diagnosed with idiopathic membranous nephropathy clearly in Guangdong Provincial Hospital of TCM and General hospital of Guangzhou Military Region from January 2008 to April 2014 were accepted. We distributed the patients to two groups,155 cases were treated in Guangdong Provincial Hospital of TCM by the Integrative Medicine therapy, but the other 128 patients were given routine western medicine therapy in General hospital of Guangzhou Military Region.Collect all the clinical and pathological data of the two groups. We observed the biochemical index on six different time points which included 0 month(the first time point),1 month(the second time point),3 months(the third time point),6 months(the fourth time point),9 months (the fifth time point) and 12 months (the sixth time point) after intervention included 24h urinary protein, Serum albumin, Creatinine, Cholesterol, Etc. Compared the clinical remission rate for half a year,1 years and the inci dence of adverse events between the two groups. The statistics were anal yzed with SPSS17.0. Results1. The treatment group:Six time points of 24h urinary protein were 4858.42 ±3252.97mg,3259.32±2700.75mg,2461.20±2288.89mg,1482.81±1508.75mg, 1078.47±1315.05mg,981.91±1554.15mg.24h urinary protein all had decrease d from 2 to 6 time points than that at 1 time point, the statistical diffe rence was significant (P<0.01). Six time points of serum albumin were 24.68 ±7.02g/L,25.74±6.26g/L,27.66±7.43g/L,29.56±6.87g/L,33.60±6.84g/L,35. 75±6.85g/L. Serum albumin and total protein all had increased from 2 to 6 time points than that at 1 time point, the statistical difference was sig nificant(P<0.01). Glomerular filtration rate had improved from 3 to 6 time points than that at 1 time point, the statistical difference was signifi cant(P<0.05). Serum total cholesterol had decreased from 2 to 6 time poin ts than that at 1 time point, the statistical difference was significant (P<0.01).Triglyceride had decreased at 5、6 time point than that at 1 time point, the statistical difference was significant (P<0.05). Serum creatini ne had decreased at 5 time point than that at 1 time point, the statistic al difference was significant (P<0.05). Uric acid, urea and hemoglobin we re no statistical difference between 2、3、4、5、6 time point and 1 time p oint (P>0.05).2. The control group:Six time points of 24h urinary protein were 3528.34±2158.77mg,2406.67±1707.85mg,2328.94±1914.47mg,1622.76±1602.29 mg,1547.80±1943.88mg,1372.00±1561.29mg.24h urinary protein all had decreased from 2 to 6 time points than that at 1 time point, the statistical difference was significant(P<0.01). Six time points of serum albumin were 25.44±6.26g/L,26.08±7.02g/L,28.26±7.26g/L,30.35±8.34g/L,32.01±7.39g/ L,32.20±7.74g/L. Serum albumin had increased at 3、4、5、6 time point tha n that at 1 time point, the statistical difference was significant(P<0.01). Total protein had increased at 5、6 time point than that at 1 time point, the statistical difference was significant (P<0.01). Serum total cholester ol, triglyceride and serum uric acid had decreased from 2 to 6 time points than that at 1 time point,the statistical difference was significant (P< 0.05). Glomerular filtration rate,Serum creatinine, urea and hemoglobin we re no statistical difference between 2、3、4、5、6 time point and 1 time p oint (P>0.05).3.The comparison between groups:24h urinary protein of the treatment group were higher than that in the control group at 1 time point, the statistical difference was significant (P<0.05). In the 1 to 4,1 to 5,1 to 6 time interval, the treatment group had a bigger change of 24h urinary protein than the control group, the statistical difference was significant(P<0.05). Serum albumin and total protein were no statistical difference from 2 to 5 time points (P>0.05), but were statistical difference at 6 time point between two groups (P<0.05). In the 1 to 5,1 to 6 time interval, the treatment group had a bigger change of serum albumin and total protein than the control group, the statistical difference was significant (P<0.05). Glomerular filtration rate were no statistical difference from 1 to 6 time points between two groups (P>0.05). In the 1 to 3 time interval, the treatment group had a bigger change of glomerular filtration rate than the control group, the statistical difference was significant (P<0.05). Serum total cholesterol of the treatment group were higher than that in the control group at 2 and 3 time points,the statistical difference was significant (P<0.05). Triglyceride of the treatment group were lower than that in the control group at 1 and 2 time points, the statistical difference was significant(P<0.05). Serum creatinine, urea, uric acid and hemoglobin were no statistical difference from 1 to 6 time points between two groups(P>0.05).4. After 6 months of treatment, the total remission rate of the treatment group was 81.3% and the control group was 68.6%, the statistical difference was significant (P,0.05). After 12 months of treatment, the total remission rate of the treatment group was 87.1% and the control group was 73%, the statistical difference was significant(P<0.05).5. Through 12 months of observation, the treatment group occurred adverse events (such as pulmonary infection, renal dysfunction, abnormal liver function) of 33 cases, while 47 cases in the control group, the statistical difference was significant(P<0.05).The treatment group occurred the renal function abnormalities (including acute kidney injury and chronic renal failure)in 9 cases,while 17 cases in the control group, the statistical difference was significant (P<0.05). Conclusion1. Traditional Chinese medicine intervention treatment scheme and western medicine scheme both has curative effect on idiopathic membranous nephropathy, but the former is more effective in reducing proteinuria level, increasing serum albumin and total protein level, protecting renal function.2.Traditional Chinese medicine intervention treatment scheme can improve the remission rate, reduce adverse event rate, has more advantages by comparing with western medicine scheme. |
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