Clinical Study Of Intergrated Chinese And Western Medicine In Refractory Nephrotic Syndrome

Objective To observe the clinical efficacy and safety of traditional Chinese and western medicine in the treatment of RNS,and to evaluate the efficacy of traditional Chinese medicine on reducing the side effects of hormones and immunizing agents.Methods During the period from September 2014 to September 2016,a total of 120 cases of refractory nephrotic syndrome were enrolled in the study.According to randomized randomized method and 2:1 ratio,they were randomly divided into experimental group(n=80)and control group(n = 40).The final observation number is 99 cases including 66 cases in the experimental group and 33 cases in the control group.With the basic treatment of high-dose hormone and cyclophosphamide,the experimental group was treat with the Chinese medicine prescription particles,the control group was treat with the placebo for 3 months.The 24 hours urine protein,plasma albumin determination,blood lipids(total cholesterol,glycerin three greases,high density lipoprotein,low density lipoprotein),coagulation/fibrinolysis(D-two dimers,fibrinogen,thrombin time,kaolin partial thromboplastin time)and TCM syndrome score were detected.Results 1.The clinical therapeutic effect of the treatment:there are 19 marked effect cases,40 effective cases and 7 invalid cases in the experimental group,6 marked effect cases,15 effective cases and 16 invalid cases in the control group.The total effective rate of the experimental group was 89.39%,of the control group was 63.64%.There was a significant statistical difference between the two groups(P<0.05).2,Comparison of TCM Symptoms:In the control group,4 cases were clinical remittent,23 cases were markedly effective,35 cases were effective,4 cases were ineffective,the total effective rate was 93.94%;in the control group,1 case of clinical remittent,3 cases markedly effective,20cases were effective,9 cases were invalid,The total effective rate was 72.73%,the difference between the two groups was statistically significant(P<0.05).3.After treatment,the effective rate of MCD,MsPGN and MPGN group was higher than that of MN and FSGS group,the difference was statistically significant(P<0.05);There was no significant difference in the TCM curative effect of different pathological types(P>0.05)4.Compared the experimental group before and after treatment,the levels of 24hUpr,Chol and TG were lower than before,the Alb was higher than before.The difference was statistically significant(P<0.05).Compared the contro group before and after treatment,the levels of 24hUpr was lower than before,the Alb was higher than before.The difference was statistically significant(P<0.05).There was no significant difference in Chol and TG(P>0.05).After treatment,the 24hUpr?Chol and TG in the experimental group was lower than that in the control group,the Alb in the experimental group was lower than that in the control group,the difference of 24hUpr?Chol?TG and Alb between the two groups was statistically significant(P<0.05).5.There was no significant difference in the BUN,Scr,ALT and AST between before and after treatment in two groups(P>0.05).There was no significant difference in BUN,Scr,ALT and AST between the two groups after treatment(P>0.05).6.After treatment,the FIB and DDG in the two groups were lower than before,the PT and APTT were higher than before,the difference was statistically significant(P<0.05).After treatment,the FIB and DDG in the experimental group was lower than those of the control group,the APTT in the experimental group was lower than that in the control group.The difference was statistically significant(P<0.05)7.After treatment,the PLT in the experimental group was lower than before,the changes of the RBC,Hb,WBC were not significant.There was a significant difference in the PLT between before and after treatment in the experimental group(P<0.05).Before and after treatment,the change of the PLT,RBC,Hb,WBC in the control group was not significant,the difference was not statistically significant(P>0.05).After treatment,the PLT in the experimental group was lower than that in the control group,the difference between the two groups was statistically significant(P<0.05);the changes of the RBC,Hb,WBC were not significant,the difference was not statistically significant(P>0.05).8.During the treatment,the incidence of Cushing's syndrome,digestive tract reaction and infection in the experimental group was lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The intergrated of traditional Chinese and Western medicine treatment can effectively improve the clinical efficacy of refractory nephrotic syndrome,improve the clinical symptoms,and the traditional Chinese medicine can effectively reduce the side effects of the immunosuppressant.