Clinical Research On Therapy Of Three Targets In The Treatment Of IgA Nephropathy With Moderate Proteinuria

Objective Proteinuria is an independent risk factor for the progress of one of Renal failure,and the treatment of Medium volume proteinuria are more controversial.The Glucocorticoid or Tripterygium wilfordii is usually a taboo drug with a variety of reasons of patient,at this time the adjustment is particularly necessary.Instructors'valid prescription(Yishen Xiezhuo) combined with small doses Tripterygium wilfordii tablets and glucocorticoid was used in this study for the treatment of IgAN in the amount of proteinuria, It is a clinical intervention with three targets which are consist of Modulates physiology,immune suppression,immune regulation and anti-inflammatory, while dynamic observing its clinical efficacy and side effects to validating the superiority of Three targets Therapy.It maybe provide evidence of evidence-based medicine for Follow-up study.Method It explored the scope of IgA nephropathy in Chinese medicine,symptom distribution,Traditional Chinese and Western Medicine Etiology,Pathogenesis and treatment Through the Documents of literature,combined with earlier research of departments.On this basis,the cases were Picked and chose in accordance with the strict inclusion and exclusion criteria according to regularity of IgA nephropathy cases in Chinese medicine hospital of Shenzhen City,then,divided into two groups by visit orderin half randomized,odd number for the treatment group,and even for the control group.The Treatment group consist of 33 cases is treated by Treatment with syndrome differentiation of TCM which is based on Xiezhuo Yishen,prednisone 20mg once a day at eight o'clock and regularly removed by six months,Tripterygium wilfordii tablets 10mg,served on three times a day,adjusted by a sudden change in the patient' s condition,while The control group that 33 cases were collected were intervened by the same therapy except TCM.Hematopiesis of the selected cases was controled below 125/75 mmHg,if it is higher,CCB orα-receptor blocker is added. Clinical manifestations and laboratory indicators of the cases were observed at the begin of March and June.Result 1) Qi Yin Deficiency Clinical Syndromes in the top six frequency for the statistical targets,the balance in the baseline case,points after treatment were lower than before within group,and it is a greater decrease in treatment group。symptoms points on lusterless complexion,weakness, afternoon tidal fever/heat in hand or foot heart,dry mouth or throat/dull red throat were compared between the treatment group and control group,and the corresponding points differences had statistical significance(P<0.01) in March and June.Poor appetite symptoms on the inter-group differences had statistical significance(P<0.01) only in June,while Lumbar pain syndrome had statistical significance(P<0.05) in June.2) There were also changes on the main indicators in laboratory,the group comparison in the plasma alanine aminotransferase and blood leukocyte count had statistically significant difference(P<0.05),while the 24-hour urinary protein and plasma cholesterol between the groups in the treatment of post-June statistical significance(P <0.05),and creatinine clearance rate in Treatment group is improving,but inter-group difference was not statistically significant.All inter-group Comparison in the 24h urinary protein had a downward trend,and the differences of pre-and post-treatment were statistically significant in 3 months and 6 months(P<0.05);the treatment group had an improvement on Creatinine clearance rate,but there was no significant difference(P>0.05),while the control group decreased compared with the initial level and diversity after 6 months made a significant difference(P<0.05);Serum alanine aminotransferase of Control group(ALT) fluctuated,which was rising in first three months with statistical significance,followed by a gradual decline, while the treatment group remained stable;in serum white blood cell count, the two groups remained stable;Plasma cholesterol levels of the control group increased,and The difference by comparison of pre-and post-treatment had statistical significance(P<0.05) in the third and sixth month.3) the number of respiratory tract infection and urinary infection in treatment group were less than the control group,and it responses similar results in the digestive tract,but the difference in the interior-group was not statistically significant until Six month later.Overall,the treatment group rate of Gastrointestinal reactions and Induced or exacerbated infection was significantly lower than the control group.Conclusion 1) Yi Shen Xie Zhuo Prescription can significantly improved the symptoms of Qi Yin Deficiency and reduced urinary protein,also stabilized renal function.2) Three target therapy is able to adjust the three main aspects of immune suppression,immune regulation and anti-inflammatory of the IgA nephropathy of Qi-Yin Deficiency and had shown good results in the efficacy and alleviation drug-related side effects,etc.Yishen Xiezhuo priscription prescription have played an important role in the treatment,also improving the quality of life of the patient.3) because of some factors such as sample size and observation time,the therapy has yet to be made an in-depth study on the long-term impact of renal function and the reproductive system lesions.