| Objective:To observe the efficacy of tonifying kidney,removing blood stasis and clearing away heat in the treatment of kidney-deficiency,blood stasis and damp-heat type idiopathic membranous nephropathy,as well as the effect on serum PLA2 R antibody,and provide a clinical basis for the treatment of IMN with integrated Chinese and Western medicine.Methods:Sixty patients with IMN who met the inclusion criteria were selected and divided into the control group and the treatment group,30 cases in each group.The two groups were given general symptomatic treatments such as antihypertensive,diuretic and anticoagulation,and the control group was given oral treatment with calcineurin inhibitor.On the basis of Western medicine treatment,the treatment group was given oral tonifying phlegm and clearing phlegm decoction.A 6-month treatment and observation.Observation indicators: Serum PLA2 R antibody,24 h urine protein quantitation,serum creatinine,serum albumin,triglyceride,total cholesterol and TCM symptom scores were measured before and during the treatment in January,March and June.Clinical analysis and safety analysis were performed by statistical analysis.Results:In this study,60 patients with IMN were enrolled,and a total of 58 patients completed the 6-month study,including 29 in the treatment group and the control group.The male to female ratio is 1.64:1,and the age distribution is 18-76 years old,with an average of 46.88±13.89 years old.After statistical analysis,there was no significant difference in the sample data before treatment(P>0.05).After treatment,serum PLA2 R antibody,urine protein quantitation,serum albumin,triglyceride,total cholesterol and TCM syndrome scores improved compared with before treatment.(P<0.05);there was no significant change in serum creatinine after treatment(P>0.05).The therapeutic effect of24 h urine protein,serum PLA2 R antibody and serum albumin was better than that of the control group(P<0.05).There was no significant difference between the two groups after treatment(P>0.05).Serum PLA2 R antibody titer levels were significantly correlated with24 h urine protein quantitation and serum albumin before and after treatment.Conclusion: tonifying kidney,removing blood stasis and clearing away heat Decoction combined with CNI in the treatment of kidney deficiency,blood stasis and dampness type IMN can effectively alleviate clinical symptoms,improve quality of life,reduce serum PLA2 R antibody and urine protein levels,increase serum albumin,and delay disease progression.Good safety and no major adverse reactions.Serum PLA2 R antibody titer level can effectively judge the patient’s condition. |
