Therapeutic Regimen And Preliminary Clinical Curative Effect On IgA Nephropathy Treated With Combination Of Disease、Syndrome And Symptoms

Objective:This study is based on the theory of TCM combining disease and syndrome to explore the therapeutic regimen for IgA nephropathy through the method of combining disease,syndrome and symptoms and to evaluate the efficacy and safety of this regimen in the treatment of IgA nephropathy,accor ding to professor Li’s academic thought on treating diseases through the combi nation of disease,syndrome and symptom,and combining with the tutor’s clinic al medication experience.The purpose is to provide a broader idea for clinical t reatment of IgA nephropathy.Methods:The first part of this study is based on professor Li’s academic t hought of treating IgA nephropathy by combining disease,syndrome and sympto m,combined with his clinical experience,exploring professor Li’s therapeutic re gimen for IgA nephropathy through the method of combining disease,syndrome and symptoms.The second part is clinical research,collecting professor Li’s IgA nephropathy patients of outpatient treatment,patients who met the criteria were treated with this therapeutic regimen for 8 weeks.Observed and recorded symp toms and signs before and after treatment,and laboratory indicators(urine sedim ent red cell count,24-hour urine protein quantification,blood creatinine,urea n itrogen,etc.).Relevant statistical methods were used to analyze the data and pre liminarily evaluate the clinical efficacy.Results:1.According to tutor’s understanding of the pathogenesis of IgA nephropath y,I analyzed and summarized my tutor’s the therapeutic regimen.The basic pres cription is composed of seven traditional Chinese medicine: Radix Astragali,R adix Salviae Miltiorrhizae,Radix Rehmanniae,Fructus Scutellariae,Cherry Fruit,Peach Seed and Coix Seed.Based on the diagnosis of the disease,the prescri ption was selected according to different syndromes:If the patient is diagnosed with wind-heat syndrome,add honeysuckle,dandelion and parsnip into the basic prescription;If the patient is diagnosed with damp-heat syndrome,scutellaria baicalensis and cardamom seed should be added into the basic prescription whe n it belongs to the dampness-heat in upper energizer;rhizoma coptidis should b e added into the basic prescription when it belongs to the dampness-heat in mi ddle energizer;cortex phellodendri and herba artemisiae should be added into th e basic prescription when it belongs to the dampness-heat in lower energizer;If the patient is diagnosed with blood-stasis syndrome,add safflower,ligusticum wallichii and angelica to the basic prescription.Besides,it is need to add differ ent Chinese medicine according to the different clinical symptoms.2.The symptoms and signs,urinary sediment red blood cell count,24-hour urinary protein quantification,serum creatinine,uric acid were observed and a nalyzed in 37 patients before and after treatment.The results showed that the to tal effective rate of disease curative effect was 56.76%,the total effective rate o f TCM syndromes was 89.18%,the total score of TCM syndromes decreased af ter treatment,and the difference was statistically significant(P<0.01),and edema was improved most obviously after treatment,the total effective rate was 80.00%.After treatment,the erythrocyte count of urine sediment and the 24-hour ur ine protein quantification decreased compared with the previous level,and the di fference was statistically significant.(P<0.01).There was no significant change in serum creatinine and blood urea nitrogen before and after treatment,and the di fference was not statistically significant(P>0.05).Conclusion:1.In the treatment of IgA nephropathy,the method of combining disease,syndrome and symptoms was adopted by my tutor.That is,according to the basic pathogenesis of the disease,the basic prescription is formulated.On this basis,according to the patient’s different syndromes and symptoms to choose different Chinese medicine.2.The basic pathogenesis of IgA nephropathy is deficiency of qi and yin,damp-heat and blood stasis.Clinically,the common syndromes are Qi-Yin deficiency combined with wind-heat syndrome、damp-heat syndrome or blood stasis syndrome,of which blood stasis syndrome is the most common.3.This regimen could significantly improve the symptoms of patients with IgA nephropathy,and reduceurine sediment red blood cell count and 24-hour urine protein quantification,and there were no adverse reactions and events occurred.It shows that this therapeutic regimen is effective,safe and reliable.