Based On The "fuxie Theory" To Guide The Treatment Of IgA Nephropathy In The Six Channels Is A Prospective Self-controlled Study Of CKD 2-4

Background:IgA nephropathy is A common primary glomerular disease in which immunoglobulin A(IgA)-based immune complex deposits in the glomerular mesangial area and hyperplasia of the glomerular mesangium is the basic histological change.Its clinical manifestations are diverse,mainly manifested as hematuria,can be accompanied by varying degrees of proteinuria,hypertension and kidney function damage,is one of the common primary glomerular diseases leading to end-stage renal disease.In terms of treatment,the exact pathogenesis of IgA nephropathy has not been clarified,so specific treatment is also lacking.It is an urgent problem to control IgAN’s disease and improve its clinical efficacy.KDIGO guidelines recommend treatment with RAS inhibitors and immunosuppressive agents,but the results are not satisfactory.An international multicenter study into the group of 262 cases of urinary protein is greater than 1 g/d IgAnephropathy patients,randomly divided into methylprednisolone and placebo groups,all patients according to the current KDIGO guidelines standardized support therapy(including the use of RSA blockers and control step-down),after an average follow-up of 2.1 years,found that more than two-thirds of methylprednisolone may reduce the risk of renal endpoint events,but the drug adverse reactions,especially infection also aern’t allowed to ignore.A Logistic regression analysis of risk factors for SAEs in glucocorticoid users concluded that glucocorticoid use in the treatment of IgA nephropathy,especially those older patients with hypertension or impaired renal function,has a higher risk of serious adverse effects,and safety issues should be considered.Thus,as the application of the hormone and immune inhibitors in patients with IgA nephropathy,patients experienced side effects and the application of appropriate patient group,the application of these drug efficacy and safety of the large sample and long-term prognosis of has yet to be more assess RCT studies further clear,so the patient to start to look for treatment of traditional Chinese medicine.In recent years,researches on TCM treatment in Michigan show that TCM has certain advantages in treating IgA nephropathy.It can control disease development in the stage of mild pathology and symptoms.In the use of hormones and other immunosuppressive agents,can play a role in reducing toxicity and enhancing efficacy;In the stage of advanced chronic renal failure,improve the quality of life,prolong the life of patients.After the continuous development of medical practitioners in past dynasties,the theory of Hidden Pathogen in traditional Chinese medicine has become quite mature.In recent years,it has been applied in clinical practice and solved some difficult medical problems.The characteristics of IgA nephropathy are recurrent and chronic,which are the same with the characteristics of hidden pathogen.ObjectiveThrough prospective self-controlled studies,the paper evaluated the urinary protein reduction,renal function protection,safety and side effects of Divide the Six Classics,which is guided by the theory of "Hidden Pathogen",in order to verify the effectiveness of Divide the Six Classics in improving renal function of IgA nephropathy patients.It provides basis for the accurate treatment of IgA nephropathy in the future.MethodsThis clinical trial is proposed Hidden Pathogen Theory instruction Divide the Six Classics of the traditional Chinese medicine treatment,the application Self controlled prospective research method,54 patients have been treated with Western medicine standardized treatment curative effect of poor patients using traditional Chinese medicine(TCM)cases of 1,3,6 months before the data are collected,and then in the Hidden Pathogen Theory under the guidance of Divide the Six Classics to patients with traditional Chinese medicine prescription,collect the group of patients with TCM 1,3,6 months after the case data.Blood routine,urine routine,24h urine protein quantification,liver and kidney function,ion were recorded for all enrolled patients at each follow-up point.Statistical analysis was conducted on the above data after the end of the experiment.Results:(1)the effective rates(measured by Scr)of a total of 54 patients at 1,3 and 6 months were 75.9%,87.0%and 87.0%,respectively.Scr of patients showed an upward trend at-6 months,-3 months,-1 months and 0 months before treatment,and a downward trend at 0 months,1 month,3 months and 6 months,with statistically significant differences(p<0.01).Before treatment,eGFR of patients at-6 months,-3 months,-1 months and 0 months showed a downward trend,while eGFR of patients at 0 months,1 month,3 months and 6 months showed an upward trend,and the difference was statistically significant(p<0.01).Before treatment,24hUTP of patients at-6 months,-3 months,-1 months and 0 months presented a downward trend,while 24hUTP of patients at 0 months,1 month,3 months and 6 months presented a downward trend,and the difference was statistically significant(p<0.01).(2)there was no significant difference in alanine aminotransferase,cereal grass aminotransferase and serum potassium between the patients at 1,3 and 6 months after treatment and the baseline before treatment(P>0.05).(3)among them,10 patients lost the pathological report,and 44 patients kept the pathological report.The effective rates were 72.72%,86.36%and 93.18%in the first,third and sixth months of treatment.Conclusion:(1)based on the "Hidden Pathogen Theory",Divide the Six Classics Treament can reduce Scr and increase eGFR in staging CKD2-4 patients.(2)based on Hidden Pathogen Theory",Divide the Six Classics Treament is a treatment that is safe without side-effects.