Experimental Study Of Tacrolimus Combined With Replenishing Qi And Promoting Blood Circulation Recipe In Treatment Of Nephrotic Primary Membranous Nephropathy

Objective:To explore the efficacy and safety of tacrolimus combined with replenishing qi and promoting blood circulation recipe in treating primary membranous nephrotic syndrome with Qi deficiency and blood stasis..Methods:60 cases of primary membranous nephropathy were selected from the First Affiliated Hospital of Henan University of traditional Chinese medicine,Henan Province People's Hospital,and central Fuwai Cardiovascular Hospital in Henan.The treatment group and the control group were randomly divided into two groups,each with 30 cases.The control group was treated with tacrolimus and WuZhi soft capsule,while the treatment group was added with replenishing qi and promoting blood circulation recipe on the basis of the control group.The indexes of urine protein,serum albumin,total cholesterol,triglyceride,creatinine,fasting blood glucose,glutamic Pyrex aminotransferase and cereal transaminase were observed at 1,3,6,9 and 12 months after treatment.The scores of TCM syndrome were evaluated,and the adverse reaction was recorded and the statistical remission rate was recorded.Results:After 12 months of follow-up,52 patients completed the treatment.After 6 months of treatment,the total remission rate of the treatment group was significantly higher than that of the control group(84.62%vs 53.85%,P<0.05),and the recurrence rate was not statistically significant(11.54%vs 26.92%,P>0.05).After 12 months of treatment,there was no significant difference in the total remission rate between the treatment group and the control group(92.31%vs 84.62%,P>0.05),but the recurrence rate of the treatment group was significantly lower than that of the control group(19.23%vs46.15%,P<0.05).After the treatment,the 24-hour urine protein in the two groups was significantly reduced(P<0.01),with the treatment group lower than that of the control group(P<0.05).The serum albumin increased significantly(P<0.01),and the treatment group was higher than that of the control group(P<0.05).The total cholesterol and triglyceride decreased significantly(P<0.01),with no statistical difference between the two groups.(P>0.05).There was no significant difference in blood creatinine,glutamic transaminase and alanine aminotransferase between before and after treatment as well as the two groups(P>0.05).After 12 months of treatment,the blood glucose levels were higher in the two groups(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).In the course of treatment,the score of TCM syndrome in two groups continued to decline,with the average score of the treatment group lower than that of the control group.And there was no statistical significance in the two groups after 1 and 3 months of treatment,but after 6,9 and 12 months of treatment(P<0.01).After 6,9 and 12 months,the curative effect of TCM syndrome in the treatment group was higher than that of the control group,and there were significant differences after 6 and 9 months of treatment 100%vs57.69%,P<0.01;100%vs69.23%,P<0.01),but after 12 months of treatment(100%vs88.46%,P>0.05).Conclusion:Combination of Chinese and Western medicine for tacrolimus plus replenishing qi and promoting blood circulation recipe has better clinical efficacy and lower recurrence rate in treating primary membranous nephropathy with Qi deficiency and blood stasis.