Tacrolimus Alone Or Combined Wuzhi Capsules For The Treatment Of Autoimmune Glomerular Disease In A Singlecenter Retrospective Study

Objective: Comparing tacrolimus combined wuzhi capsules and tacrolimus therapy autoimmune glomerular disease the efficacy,safety,drug – economics.Methods: Retrospectively analyzed first affiliated hospital of dalian medical university between January 2011 and December 2015 lines of renal biopsy,which is confirmed for autoimmune glomerular diseases with a large number of patients with proteinuria.all patients were used prednisone 60 mg/d to eight weeks,every 2 weeks after reduction 2.5 mg to 10 mg/d.When glucocorticoid treatment for 8 weeks,according to the sequential therapy is divided into two groups: a group of tacrolimus group alone,starting dose of 0.05 mg/kg,Q12 hours on an empty stomach,adjust blood drug concentration of 5-10 ng/ml.Main evaluation index is cumulative response rate,response rate each time point,tacrolimus standard doses and so on,secondary evaluation index is drug side effects.A set of tacrolimus combined wuzhi capsules,wuzhi capsule starting dose for two,two times a day,monitoring tacrolimus blood concentrations of wuzhi capsules dosage adjustment each time 1 grain to amount to mark.All of the patients,followed up for 1 times a month after the start of hormone therapy,complete remission after 3 months follow-up,patients with record hepatic function,renal function,tacrolimus,blood drug concentration,blood sugar,blood fat,24 hours urinary protein quantitative,routine urine and blood tests,blood pressure and adverse events.Results: Sixty patients were included in this study,which use the tacrolimus group 30 cases,tacrolimus combined wuzhi capsules group 30 cases.The baseline clinical index of the differences between the two groups inclued the pathological types such as sex,age,24 hours urine protein,albumin,serum creatinine and quantitative hepatic function,blood glucose,blood pressure were no statistical difference.The median follow-up time was 9 months.3 and 6 months after the start of treatment,the tacrolimus group,tacrolimus combined wuzhi capsules group total response rate(complete remission,partial remission)total remission rate are 10% and 10%respectively;40%,66.7%,statistically significant;Treatment of 12 months total response rate was 71.4%,81.8% respectively,has statistical difference between the two groups.To compare the side effects of two groups such as high blood sugar,such as infection,liver meritorious service is abnormal,no statistical differences.Tacrolimus combined wuzhi capsules group take PR time point in advance,at the same time reduces the effective dose of tacrolimus.In 60 patients with tacrolimus group of tacrolimus effective dose was 3.33±1.481 mg/d,PR time point 5.22±2.58(m);tacrolimus combined wuzhi capsules group effective dose was 2.47±1.532mg/d,PR time point 2.60 ± 1.88(m),effective dose,PR time point have a statistically difference between the two groups.Another tacrolimus combined wuzhi capsule group use of the drug economics benefits lower than tacrolimus alone,so as the idiopathic membranous nephropathy subgroup analysis results.Conclusions: Tacrolimus joint wuzhi capsule can effectively treat autoimmune glomerular diseases,the use of tacrolimus can reduce the drug dosage and reduce the cost of treatment.