Clinical Observation And Scale Response Evaluation Of Simiao Powder Flavored In The Treatment Of Idiopathic Membranous Nephropathy With Dampness-heat Syndrome

Objective: To investigate the efficacy and safety of modified Simiao powder by observing the clinical efficacy and indexes of modified Simiao powder in the treatment of dampness-heat syndrome of idiopathic membranous nephropathy.It provides the diagnosis and treatment idea for idiopathic membranous nephropathy in clinic.To evaluate the response degree of dampness-heat syndrome diagnostic scale of idiopathic membranous nephropathy,and to provide help for quantitative diagnosis of TCM clinical syndromes and clinical efficacy evaluation of idiopathic membranous nephropathy.Methods: A total of 72 patients diagnosed as idiopathic membranous nephropathy by renal puncture biopsy or anti-PLA2 R antibody detection were selected and randomly divided into two groups.On the basis of conventional Western medicine treatment,modified Simiao powder was added to the treatment group,and Huangkui capsule was added to the control group.The observation time was8 weeks.The indexes of albuminuria,albumin,lipid,renal function and TCM syndrome scores of idiopathic membranous nephropathy diagnosis scale were recorded before and after treatment in both groups.Results:There were 2 cases of shedding in the experimental group and the control group.(1)Clinical efficacy:the effective rates of disease in the treatment and control groups were 88.24% and 67.65% respectively.The treatment group was better than the control group(P<0.05).(2)therapeutic effect index : There was no statistically significant difference in all therapeutic effect index between the two groups before treatment(P>0.05).Intra-group comparison of proteinuria(24h UP,MALB,UPRO/UCr): the proteinuria index was lower in the treatment group than before treatment and the differences were statistically significant(P<0.05).The differences between MALB and UPRO/UCr in the control group were not statistically significant(P>0.05).After treatment the improvement of proteinuria indexes in the treatment group was better than that in the control group with a statistically significant difference(P<0.05).Intra-group comparison of albumin(ALB): ALB in both groups was higher than before treatment,and the differences were statistically significant(P<0.05).ALB was higher in the treatment group than in the control group after treatment with a statistically significant difference(P<0.05).Within-group comparison of blood lipids(TG,CHOL): TG and CHOL in the treated group were lower than before treatment,and the differences were statistically significant(P<0.05).The differences in the control group were not statistically significant(P>0.05).After treatment TG in the treatment group was lower than that in the control group and the difference was statistically significant(P<0.05).The difference in CHOL was not statistically significant(P>0.05).Within-group comparison of renal function(Scr,BUN,UA): the differences in Scr and BUN in the treated group were statistically significant(P<0.05)and the difference in UA was not statistically significant(P>0.05).None of the differences in renal function in the control group were statistically significant(P> 0.05).After treatment BUN in the treatment group was lower than that in the control group and the difference was statistically significant(P<0.05).The differences in Scr and UA were not statistically significant(P>0.05).(3)Curative effect of TCM syndrome: The improvement of internal heat,dampness and turbidity and total surface dimension integration in treatment group was better than that in control group with a statistically significant difference(P<0.05).The effective rate of TCM symptoms in the treatment group was 88.24% better than41.18% in the control group(P<0.05).(4)Scale response evaluation: the syndrome scores of internal heat,moist-turbidity dimension and total scale integral dimension were lower in the treatment group after treatment than before and the difference was statistically significant(P<0.05).The differences of red tongue,yellowish coating and slippery pulse were statistically significant(P<0.05).The scale effect was 9.71,which was a large effect.(5)Safety evaluation: there were no obvious adverse reactions during treatment in the two groups.Conclusion: Simiao Powder has good clinical efficacy in the treatment of dampness-heat syndrome of idiopathic membranous nephropathy,which can reduce clinical symptoms,reduce quantitative scores of TCM syndromes,improve therapeutic effect index without obvious adverse reactions.The dampness-heat syndrome diagnostic scale of idiopathic membranous nephropathy has a good response.The scale can provide help for quantitative diagnosis of clinical syndromes and efficacy evaluation of idiopathic membranous nephropathy.