| Objective:To evaluate the efficacy and safety of Jianpi Qushi Heluo Decoction in the treatment of IMN by the clinical observation of 12 months of IMN treatment withJianpi Qushi HeLuo Decoction.Methods:From June 2016 to January 2019,he was treated at the NephrologyClinic of Xiyuan Hospital of China Academy of Chinese Medical Sciences fromJanuary 2016 to January 2019.IMN patients treated with Jianpi Qushi Heluo Decoctionwere treated for more than 12 months.Clinical observation,observation time node was0、3、6、12 months after treatment,the main observation indicators were 24-hour urineprotein quantitation,plasma albumin,TCM syndrome scores and so on.According tothe patient’s previous treatment of hormone therapy,the patients were divided into theinitial TCM treatment group and the refractory IMN TCM treatment group and theefficacy analysis was carried out.Results:(1)A total of 179 patients with IMN were included,of which 2 wereshedding,3 were excluded,and 47 were less than 12 months.127 were actuallycompleted.60 patients who had not been treated with hormones and/orimmunosuppressants were the initial TCM treatment group.67 patients with hormonedependence or repeated recurrence who had been treated with hormone and/orimmunosuppressive therapy for 6 months were the refractory IMN TCM treatmentgroup.(2)Overall efficacy:127 patients were treated for 12 months,33 patients(26.0%)were completely relieved,75 patients(59.06%)were partially relieved,19 patients(14.96%)were invalid,and the total remission rate was 85.04%.After 12 monthstreatment,24-hour urine protein quantitation decreased from 5.31±3.13 beforetreatment to 1.67±1.09 after treatment(P<0.01),and plasma albumin increased from30.49±7.13 before treatment to 37.91±16.66 after treatment(P<0.01),TCM syndromescore decreased from 49.21±6.37 before treatment to 4.60±3.09 after treatment(P<0.01),total cholesterol decreased from 7.49±2.76 before treatment to 5.74±1.65after treatment(P<0.01),triglyceride was reduced from 3.25±2.42 before treatment to 2.43±1.65 after treatment(P<0.01).(3)The efficacy of grouping:After 12 months of treatment,60 patients in the initial TCM treatment group,15 patients(25%)with complete remission,37 patients(61.67%)with partial remission,8 patients(13.33%)with invalid,the total remission rate was 86.67%.After 12 months of treatment,the 24-hour urine protein quantitation decreased from 5.26±2.91 before treatment to 1.64±1.04 after treatment(P<0.01),and plasma albumin increased from 30.60±6.61 before treatment to 38.26±5.89 after treatment(P<0.01),TCM syndrome scores decreased from 47.88±6.63 before treatment to 4.47±2.89(P<0.01),total cholesterol decreased from 7.22±2.96 before treatment to 5.43±1.48(P<0.01)after treatment,triglyceride decreased from 3.02±2.68 before treatment to 2.32±1.83 after treatment(P<0.05).There were 67 cases of refractory IMN TCM treatment group,18 cases(26.87%)with complete remission,38 cases(56.72%)with partial remission,and 11 cases(16.42%)with invalid,the total remission rate was 83.58%.After 12 months of treatment,24-hour urine protein quantitation decreased from 5.50±3.37 before treatment to 1.72±1.64(P<0.01),and plasma albumin increased from 30.39±7.62 before treatment to 37.40±7.33 after treatment(P<0.01),TCM syndrome score decreased from 50.37±3.62 before treatment to 4.70±3.28(P<0.01),total cholesterol decreased from 7.77±2.55 before treatment to 6.10±1.80(P<0.01)after treatment,triglyceride decreased from 3.48±2.12 before treatment to 2.60±1.48 after treatment(P<0.05)(4)Remission time:The overall remission time was 5.67±3.32 m,and the TCM syndrome remission time was 1.97±0.80 m.The initial TCM treatment group:the remission time was 6.12±3.36 m,the remission time of TCM syndrome was 2.03±0.80 m;The refractory IMN TCM treatment group:the remission time of was 5.25±3.25 m,TCM syndrome remission time is 1.93±0.79 m(5)Safety analysis:There was no significant change in the safety indexes of blood,urine,stool and liver and kidney function before and after treatment(P>0.05),and the difference was not statistically significant.(6)Adverse reactions and adverse events:During the treatment.1 patient with diarrhea,1 patient with pulmonary infection,2 with upper respiratory tract infection,and 1 patient with transient liver function.Conclusions:1.The traditional Chinese medicine treatment program based on Jianpi Qushi Heluo Decoction is safe and effective in treating IMN,which can significantly reduce the proteinuria level of IMN patients and improve the plasma albumin level.2.Jianpi Qushi Heluo Decoction can also improve blood lipid metabolism in patients with IMN.3.Jianpi Qushi Heluo Decoction also have good clinical efficacy in patients with refractory IMN,and fewer adverse reactions.4.The main pathogenesis of IMN is spleen and kidney qi deficiency and wind,dampness and heat evil.Using spleen and dampness and collaterals to strengthen the spleen and replenish qi,ascending dehumidification,hurricane and collateral are the main treatments.Improve the clinical symptoms of patients with TCM and improve the quality of life of patients. |
