| Purpose:The purpose of this study is to observe the effect of hormone on the integral of TCM symptoms and side effects caused by hormone in patients with primary nephrotic syndrome of water-wet immersion type and spleen-kidney Yang deficiency type before and after induction period.To explore the mechanism and potential law of hormone induced side effects in TCM,and to provide reference and theoretical basis for alleviating hormone side effects.To explore the mechanism and potential regularity of hormone-induced side effects in traditional Chinese medicine,so as to provide reference and theoretical basis for alleviating hormone side effects.Material and method:All the included patients met the criteria for the diagnosis of primary nephrotic syndrome.According to the TCM syndromes,90 patients were classified as water-wet-immersion type,and 90 patients were classified as spleen-kidney Yang deficiency type.A total of 180 patients were included in this study.These cases were all from outpatients and inpatients in the department of nephrology of the former shenyang military region general hospital of the northern theater general hospital from June 2016 to June 2018.Patients in the two groups were given general treatment(low-salt and high-quality protein diet,etc.),symptomatic treatment(diuretic detumescence,reduction of urinary protein,anticoagulant treatment,lipid-lowering treatment,etc.),and glucocorticoid treatment.At the same time,observe the two groups of patients before treatment and after 8 weeks of treatment:(1)TCM syndrome scores;(2)adverse reactions during the full use of hormones;(3)24-hour urinary protein quantification,urinary microalbumin/creatinine ratio,serum albumin,serum creatinine,urea nitrogen,total cholesterol,triglyceride,fasting blood-glucose,hemoglobin before and after 8 weeks of treatment.SPSS21.0 software was used to analyze the observed index data and compare the differences between the two groups.Results:1.There was no significant difference in serum creatinine,urea nitrogen,albumin,uric acid,urinary ACR and 24-hour urinary protein between the two groups before treatment(P > 0.05).It can be concluded that the baseline of the two groups before treatment was the same and hada balanced comparability.2.The average age of patients with spleen-kidney Yang deficiency is higher than that of patients with water-wet impregnation,indicating that PNS patients in young and middle-aged people are more likely to present as water-wet impregnation type,while PNS patients in middle-aged and elderly people are more likely to present as spleen-kidney Yang deficiency type.3.The total effective rate of TCM syndromes was 81.11% in the water-wet immersion group and 50% in the spleen-kidney Yang deficiency group.The difference of clinical effect between the two groups after treatment has statistical significance.It shows that the total effective rate of hormone in patients with water-wet immersion is better than that in patients with spleen-kidney Yang deficiency.It also shows that the sensitivity of hormone in patients with water-wet immersion is significantly higher than that in patients with spleen-kidney Yang deficiency.4.In terms of clinical efficacy,the total effective rate was 80% in the water-wet immersion group and 68.89% in the spleen-kidney Yang deficiency group.The difference of clinical efficacy between the two groups showed that the total effective rate of hormone in patients with water-wet immersion was better than that in patients with spleen-kidney Yang deficiency,indicating that the sensitivity of hormone in patients with water-wet immersion was significantly higher than that in patients with spleen-kidney Yang deficiency.5.For Cushing's syndrome,femoral head necrosis,hyperglycemia,glaucoma and other side effects,patients with water-wet immersion were higher than those with spleen-kidney Yang deficiency.The difference in the incidence of side effects between groups showed that patients with water-wet immersion were more likely to have the above side effects.For aggravating side effects such as infection,gastric ulcer,gastric hemorrhage and nervous system symptoms,patients with spleen-kidney Yang deficiency type were higher than those with water-wet immersion type.The difference in the incidence of side effects between groups was significant,indicating that patients with spleen-kidney Yang deficiency type were more likely to have the above side effects.6.Statistical analysis of the incidence of side effects of hormones showed that the incidence of water-wet-impregnated patients was higher than that of spleen-kidney-yang deficiencypatients.The difference of the incidence of side effects between groups showed that water-wet-impregnated patients were more likely to have the above side effects.At the same time,the degree of TCM side effects of two groups of patients after treatment was statistically analyzed.The results showed that the degree of TCM side effects of water-wet-impregnated patients were more serious than those of spleen-kidney-yang deficiency patients.The difference was statistically significant,indicating that water-wet-impregnated patients had more serious side effects of TCM.Conclusion:1.PNS patients in young and middle-aged people are more likely to present as water-wet impregnation type,while PNS patients in middle-aged and elderly people are more likely to present as spleen-kidney Yang deficiency type.2.Hormones can improve the efficacy of TCM syndromes and clinical effects in patients with PNS water-wet-immersion type and spleen-kidney Yang deficiency type,and the total effective rate in patients with water-wet-immersion type is significantly higher than that in patients with spleen-kidney Yang deficiency type.It can be considered that the hormone sensitivity of patients with water-wetting immersion type is higher than that of patients with spleen-kidney Yang deficiency type.3.Patients with water-soaked PNS are more prone to Cushing's syndrome,femoral head necrosis,increased blood glucose,glaucoma and other side effects.Patients with spleen-kidney Yang deficiency type PNS are more likely to have side effects such as aggravated infection,gastric ulcer,gastric bleeding and neurological symptoms.4.Traditional Chinese medicine side effects may occur in patients with both water-wet PNS and spleen-kidney Yang deficiency with hormone therapy,but the incidence of side effects in patients with water-wet PNS is higher than that in spleen-kidney Yang deficiency,and the degree is relatively more serious.5.The curative effect and side effects of hormones on patients with PNS water-wet-immersion type and spleen-kidney Yang deficiency are quite different.Moreover,as the effects of hormones are warm and easy to consume Yin fluid,it is suggested that proper strengthening of nourishing Yin and clearing away heat may improve the curative effect and reduce sideeffects when using hormones to treat patients with water-wet-immersion type. |
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