The Observation On Mid-Long Term Clinical Efficacy Of Idiopathic Membranous Nephropathy By Treatment Of Chinese Aad Western Medicine

Objective:In this article,the total effective rate,adverse reactions and recurrence after discontinuation are compared of Combination of the Western Medicine and Traditional Chinese Medicine,Glucocorticoid combined with cyclophosphamide/Tacrolimus treating for idiopathic membranous nephropathy(IMN).In order to analyze the effectiveness and safety of two regimens in the treatment of IMN.Methods:From January 2016 to December 2017,41 IMN patients from outpatient department of the Chinese Medicine Department in Wuxi Nanzhan Hospital,and 31 IMN patients from outpatient department and ward of the Department of Nephrology in Wuxi People’s Hospital.They were divided into three groups according to different treatments.Among them,the combination of chinese medicine treatment according to syndrome differentiation and treatment with hormones and immunosuppressive agents were treated in TCM-WM group,the treatment with combination of hormones and immunosuppressive agents was treated in WM group.The changes of 24 hours protein quantification,ALB and eGFR were observed before and after therapy in three groups,and the effective rate,recurrence rate and incidence of adverse reactions were compared as well.Results:1)All the two treatment regimens can effectively reduce the urine protein of IMN patients,and increase the serum albumin level.In the follow-up after 6 months and 12 months treatment,WM group(45.2%,87.1%)was more effective than TCM-WM Group(29.3%,56.1%),the P value was 0.043 and 0.001 respectively.After 18 months treatment,TCM-WM group(87.8%)was more effective than WM group(71%)(P=0.026).To the end of the follow-up after 24 months treatments,the effective rate of TCM-WM group and WM group were 85.4%and 742%,respectively.And there is no statistical difference between the two groups of data.2)After 24 months treatment,the renal function of the two groups remained stable,and there was no significant difference of eGFR from pre-treatment(P>0.05).3)After 24 months treatment,2/41 cases(4.9%)recurred in TCM-WM group were significantly lower than that in WM group,which is 10/31 cases(32.3%).And the difference was statistically significant(P<0.05).4)After 24 months of clinical observation,12/41 patients(29.3%)who has adverse reactions in TCM-WM group were significantly lower than 16/31 patients(51.6%)in WM group,and the difference was statistically significant(P<0.05).Conclusion:1.Western medicine group can reduce the 24-hour urine protein level and increase serum albumin(ALB)level of IMN patients fast,but after 24 months of follow-up,the effective rate of TCM-WM group is higher than that of WM group.2.Dialectical treatment of traditional Chinese Medicine has a certain effect on long-term protection of renal function.3.The recurrence rate of TCM-WM group were significantly lower than that of WM group.4.The incidence of side effects was significantly lower in TCM-WM group than in WM group.