Analysis Of Clinical Effect And Medication Rule In Treating All Ergic Purpura Nephritis With Syndrome Differentiation By Professor Zhang Peiqing

Objective: In this study,clinical data of 105 patients with HSPN were retrospectively analyzed to study and analyze the efficacy of using Professor Zhang Peiqing’s experience in the treatment of HSPN.At the same time,based on the traditional Chinese medicine inheritance auxiliary platform system,in-depth excavation of my tutor Professor Zhang Peiqing’s prescription medication rules,to provide a more effective diagnosis and treatment scheme for the clinical treatment of HSPN.Methods: 1.Clinical data of 105 patients with Henoch-Schonlein purpura nephritis who were diagnosed as allergic nephritis in the Second and Eighth Department of Nephrology of our hospital from January 2014 to December 2020 were collected and retrospectively analyzed.Changes in urinary protein content and urinary red blood cell count at 24 hours before and 4 weeks after treatment were observed.The changes of glomerular filtration rate(EGFR)and serum creatinine(CR)were observed before and after treatment.2.Based on the traditional Chinese medicine inheritance auxiliary platform,systematic analysis was made of the prescription medication rules of Professor Zhang Peiqing’s treatment of HSPN based on syndrome differentiation.Results: 1.Comparison of patients’ general conditions: A total of 105 HSPN patients were included in this study,including 34 male patients(32.38%)and 71 female patients(67.62%),with a male to female ratio of 1:2.08.The patients ranged in age from 46-60 years old,with an average age of 42.43 years old.2.Comparison of TCM syndromes distribution:The TCM syndromes of 105 HSPN patients included in this study were divided into 7syndromes.Among them,33 cases(31.43%)had the deficiency of both Qi and Yin and the syndrome of dampness and heat.Deficiency of spleen and kidney,dampness-heat syndrome in 26 cases(24.76%);Blood heat internal stasis,vein injury syndrome,damp-heat intrinsic syndrome 14 cases(13.33%);Kidney Yin deficiency,internal heat stasis in 11 cases(10.48%);Insufficiency of qi and blood,blood loss in 6 cases(5.71%);Deficiency of spleen and kidney,qi stagnation and blood stasis in 1 case(0.95%).3.Comparison of laboratory efficacy indicators: 3.1 Before and after treatment(4 weeks of treatment),24-hour urinary protein content and urinary red blood cell count showed a gradually decreasing trend;The24-hour urinary protein level and urinary erythrocyte count at 4 weeks after treatment were decreased compared with those before treatment(P<0.05).3.2 The glomerular filtration rate(EGFR)was significantly increased after treatment compared with before treatment(P<0.05);The serum creatinine(CR)was significantly decreased after treatment compared with before treatment(P<0.05).4.Comparison of clinical efficacy before and after treatment:the total effective rate of clinical remission was 98.10% at the 4th week of treatment,and the TCM clinical syndrome score was significantly decreased after treatment compared with before treatment(P<0.05).5.Comparison of therapeutic efficacy: There were a total of 9therapeutic regimens."Traditional Chinese medicine alone" was the most commonly used treatment regimen,followed by "traditional Chinese medicine + hormone".The former had the best overall effect,while the latter had the second best.6.According to the inheritance of traditional Chinese medicine auxiliary platform system statistics,including drug use frequency is highest is licorice,astragalus membranaceus and dangshen,then spreading hedyotis herb,poria cocos,Cherokee rose,radix bupleuri,barbed skullcap herb,angelica sinensis,cortex moutan,etc.,from which it is not hard to see,overall are mainly composed of tonifying qi and nourish Yin,and clinical tests,through further extraction and formed different medicine group and the new prescription.Conclusion: 1.From the perspective of traditional Chinese medicine,patients with HSPN can be roughly divided into seven syndrome types.The first syndrome type is deficiency of Qi and Yin,and dampness-heat syndrome;The second syndrome type is deficiency of spleen and kidney,dampness-heat syndrome;The third syndrome type,blood heat and internal stasis,vein injury syndrome;The fourth syndrome type is dampness-heat syndrome;The fifth syndrome type is kidney Yin deficiency,internal heat stasis syndrome;The sixth syndrome type is insufficiency of qi and blood,blood loss syndrome;The seventh syndrome type is deficiency of spleen and kidney and qi stagnation and blood stasis.Relevant statistical data show that the first two syndrome types are the most common in HSPN patients.2.The curative effect results showed that HSPN patients treated by Professor Zhang Peiqing had a great degree of improvement in reducing proteinuria and hematuria,which showed a significant effect on the protection of kidney function and the improvement of TCM syndrome.3.Among the treatment regimens,"traditional Chinese medicine alone" had the highest effective rate,while "traditional Chinese medicine + hormone" had the highest effective rate.4.Professor Zhang Peiqing treats HSPN with both cleansing and tonifying,caring for spleen and stomach from time to time,and emphasizing regulating liver and spleen qi mechanism.The drugs were mainly sweet,cold,liver and spleen drugs.The core drug group included Radix Platyclae Radix-Rubiae Radix-Platycladus orientalis Leaf.Dangshen-Sophora flavescens-Anemarhizae;Rehmannia glutinosa-Cornus officinalis-Alisma alismatis;Fructus Aurantii-raw keel-head black vine;Blood charcoal-raw elm-lotus root joint,etc.