Clinical Observation On Treatment Of IgA Nephropathy With Er Ban Tang

BACKGROUND:IgA nephropathy is a primary glomerular disease characterized by recurrent hematuria or microscopic hematuria,mesangial IgA deposition,or IgA deposition.Infection,especially recurrent tonsil infection,is closely related to the development of IgA nephropathy.Under genetic polymorphic background^[1],IgA1 produced by mucosal immunity,especially glycosylation defects in tonsil lymphoid tissue,is considered to be an important pathogenesis of IgA nephropathy^[2-3],and that repeated tonsil infections can be formed.Hidden lesions cause imbalance of the immune function of the tonsils and induce glomerular diseases such as IgA nephropathy.Repeated episodes of tonsillitis are important factors affecting IgA nephropathy aggravation,relapse,treatment difficulties,and poor prognosis^[4-7]。Selecting Drugs According to the Thinking of Identifying the Guijing Properties of Disease^[12]is a group of prescription medicine methods studied by Professor Guan Jinghuan of the old Chinese medicine tube.Based on many years of clinical diagnosis and treatment experience,the principle of total treatment for treating IgA nephropathy with tonsillitis is summarized.Method^[13],and formulate common experience in treatment-Er Ban Tang^[13].For the inheritance and development of Chinese medicine for the prevention and treatment of kidney disease provide a better treatment.OBJECTIVE:Qing Shang Gu Xia Fa as a general principle of treatment To treat IgAN,Selecting Drugs According to the Thinking of Identifying the Guijing Properties of Disease,Observing the clinical efficacy of Er Ban Tang in the treatment of patients with IgAN with tonsillitis aims to explore new effective treatment ideas for the treatment of IgAN in order to prevent and delay the development of IgAN,prevent relapse.and explore new effective treatment ideas.METHODS:Patients with IgAN complicated with tonsillitis who met the diagnostic criteria were randomly divided into two groups,31 in the treatment group and 29 in the control group.Both groups were given basic treatment,and the treatment group was given another Chinese herbal decoction-Er Ban Tang.The course was 4 weeks and1 course of treatment.There were a total of 3 courses of treatment.After the end of the treatment,they were followed up for 6 months.The scores of TCM symptom scores,laboratory indicators（white blood cell,C-reactive protein,urine red blood cell count,urinary red blood cell variant ratio integral,urinary protein quantification,urinary protein creatinine ratio）were recorded before,during,and after 12 weeks of treatment.Serum albumin,serum creatinine,glomerular filtration rate);Record the number of relapse cases and recurrence factors in the follow-up six months.The change of each index of the patient before and after treatment and the follow-up recurrence were compared.RESULTS:64 cases were observed and 4 cases were withdrawn.Finally,60cases were included in the analysis,including 31 cases in the treatment group and 29 cases in the control group.There was no statistical difference between the two groups of patients ingeneral information such as age,gender,disease course,Oxford pathological type,and so on.（1）After 4 weeks of treatment,hematuria of the patients in the treatment group was significantly reduced or disappeared,and the quantitative scores of TCM symptoms were significantly decreased.The difference was statistically significant（P<0.05）.Proteinuria,albumin,C-reactive protein,white blood cell count,serum creatinine,and glomerular filtration rate were all changed,but the difference was not statistically significant.（2）After 12 weeks of treatment:1 The total effective rate（83.87%）of the treatment group in the comprehensive evaluation of chronic nephritis was significantly higher than that of the control group（55.17%）（P<0.05）;2 Hematuria and proteinuria in the treatment group Significantly lower than before,the difference was statistically significant（P<0.05）;patients with serum albumin levels increased compared with before treatment,a statistically significant difference（P<0.05）.3 The serum creatinine decreased and the glomerular filtration rate increased in the treatment group were statistically significant（P<0.05）.4 The inflammatory indexes such as C-reactive protein and white blood cell count in the treatment group were significantly lower than those before treatment（P<0.05）;inflammatory symptoms such as tonsillar congestion,redness,or pus and purulent plug were obvious Improved（P<0.05）.（3）After treatment for 12 weeks,the total effective rate of the comprehensive curative effect of TCM syndrome in the treatment group was 90.32%,especially for relieving or eliminating single TCM syndromes such as sore throat,hematuria,flu,and weak waist and knees.Significant advantage（P<0.05）.（4）During the follow-up observation period,the relapse rate was 6.45%in the treatment group,and the recurrence rate was 6.45%in the control group.The recurrence rate was 31.03%in the control group（P<0.05）.The tonsillectomy accounted for 66.67%of the recurrence factors.CONCLUSION:（1）In combination with basic drugs for the treatment of patients with IgAN with tonsillitis,Er Ban Tang can significantly improve TCM syndrome scores,laboratory indicators,and improve the clinical remission rate of IgAN with tonsillitis.（2）In combination with basic drugs for the treatment of IgAN with tonsillitis,Er Ban Tang can significantly improve the renal function and increase the glomerular filtration rate.（3）The rate of follow-up recurrence of patients with IgAN complicated with tonsillitis was significantly lower than that of the control group.This suggests that combined treatment with traditional Chinese and Western medicine may improve the long-term prognosis of IgAN.