| Objective :To evaluate the efficacy and safety of tacrolimus combined with Wu Zhi soft capsule in treatment of nephrotic idiopathic membranous nephropathy in comparison with the protocol of glucocoticoid hormone combined with Cyclophosphamide(CTX).Methods:60 patients with nephrotic idiopathic membranous nephropathy were included in the study, 38 patients receiving tacrolimus, started with a dose of 2mg/d, divided into 2 daily doses,fasting oral 1 hour before meals.The doses of tacrolimus were adjusted according to the blood trough level.Wu Zhi soft capsule started with a dose of 1.5g/d, divided into 3 daily doses,fasting oral 0.5 hour after meals.Others receiving CTX combined with glucocorticoid treatment, prednisone started with a dose of 0.5mg/kg/d,early morning meal doses.CTX started with a dose of 8mg/kg/d,1 once daily,for 2 consecutive days,then 1 once a month,for six consecutive months.The accumulative dose of CTX was less than 150mg/kd(total 6~8g).The patients were followed for 12 months,then observe the changes of 24-hour urine quantification, albumin,serum creatinine, alanine transaminase,aspertate aminotransferase and blood glucose,infection and side effects in 2 groups.Results:60 patients all completed therapy.After the 6th month, remission was observed in 15 patients(68.18%) in CTX group, and 28 patients(73.69%) in tacrolimus group. Proteinuria was significantly decreased after treatment in both groups(P<0.05),Serum albumin was significantly increased in both groups after treatment(P<0.05). Serum creatinine alanine transaminase,aspertate aminotransferase and blood glucose were comparable between before and after treatment.Conclusion :Tacrolimus combined with Wu Zhi soft capsule in treatment of nephrotic idiopathic membranous nephropathy has a significantly curative effect.Its short-termm efficacy might be better than the protocol of glucocoticoid hormone combined with Cyclophosphamide. |
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