| BackgroundGlomerulonephritis(GN)is the common cause of end-stage renal disease(ESRD).In recent years,with the development of the pathogenesis of glomerulonephritis,the treatment of glomerulonephritis has become increasingly targeted and specific.A treatment system based on renin-angiotensin-aldosterone system inhibitors,glucocorticoids,immunosuppressants and targeted drugs has been formed,among which the application of immunosuppressant is of great benefit to GN patients’ recovery.but considering that most patients with glomerulonephritis have a long clinical course and need to take medicine for a long time,extensive use of immunosuppressant may cause adverse reaction,toxic effects,and further inhibit the body’s immune function to induce other diseases.Besides,the immunosuppressants used in clinical practice are relatively expensive,therefore efforts have been put into act to actively explore new drugs with high economic benefits,low side effects,and good therapeutic performance.In traditional Chinese medicine,some traditional Chinese herbs have been proved to have the effect of immunosuppression.It has been proved by a large number of clinical studies that the traditional Chinese medicine immunosuppressants represented by tripterygium wilfordii polyglycosides have a prominent role in the treatment of glomerulonephritis,the relief of clinical symptoms,and the improvement of related indicators and quality of life.Some studies have found that T.hypoglaucum can inhibit the body’s inflammatory response,reduce the inflammatory immune function and reduce the urine protein.However,most of these drugs have toxic and side effects such as gonadal toxicity,digestive tract toxicity,renal toxicity.bone marrow suppression,etc.,which can affect the fertility of patients,cause digestive tract discomfort and damage renal function.Some of these side effects are unbearable.Kunxian capsule is the result of Chinese medicine research project.Which mainly includes T.hypoglaucum,Epimedium,Lycii Fructus and Cuscuta.The main extract of epimedium is icariin,which has the functions of anti-osteoporosis,anti-inflammation,steroids-like effect and improving hematopoietic function.The main extract of lycii Fructus is betaine,which can promote hematopoiesis and protect liver.The main extract of Cuscuta is flavonoids,which has estrogen-like effect and the function to improve reproductive ability,protect liver and promote the activity of osteoblasts.Kunxian capsule can theoretically antagonize the gonadal toxicity of Tripterygium hypoglaucum without affecting its anti-inflammatory and immunosuppressive effect.So it is widely applied in the treatment of immune-related diseases such as ankylosing spondylitis(AS),systemic lupus erythematosus(SLE),nephrotic syndrome,chronic nephritis and so on.However,there are only a few related research and follow-up investigation on Kunxian capsule in the treatment of glomerulonephritis.ObjectiveTo explore the short-term efficacy and safety of basic treatment combined with Kunxian capsule in the treatment of glomerulonephritis.MethodsThe cases were collected from the outpatient of the Department of Nephrology in Qilu Hospital of Shandong University from February 2019 to July 2019.A total of 61 cases were included and treated with Kunxian capsule in addition with basic treatment.All patients were followed up in outpatient for 2 months and did urine routine,Urinary Protein creatinine ratio(UACR),Serum creatinine(Scr),Blood urea nitrogen(BUN),Albumin(ALB),White blood cell count(WBC),Platelet count(PLT)and other related indicators every month.The patients were divided into different subgroups based on age,sex and blood creatinine to analyze the short-term efficacy of Kunxian capsule in glomerulonephritis.Results1.This study inculded 61 glomerulonephritis patients,and all of them were treated with basic treatment combined with Kunxian capsule.After 1 month,4 cases were clinically controlled,8 cases were evidently effective,10 cases were effective and 39 cases were ineffective.The total effective rate was 36.07%.After 2 months treatment,6 cases were clinically controlled,12 cases were evidently effective,18 cases were effective and 25 cases were ineffective.The total effective rate was 59.02%.2.During the follow-up period,there was no significant difference in Scr between base line,1 month and 2 months after treatment(P>0.05).Yet there was significant difference in BUN(P<0.05).UACR decreased significantly compared with that before treatment(P<0.05)3.According to the level of Scr,patients were divided into normal group and abnormal group.There was no significant difference in BUN before and after treatment in the two groups(P>0.05).UACR decreased significantly in both normal and abnormal groups(P<0.05).There was no significant difference in the variation of BUN and UACR between the normal group and the abnormal group before treatment,after 1 month and 2 months treatment(P>0.05).4.The patients were divided into age≥60 years and age<60 years.There was no significant difference in Scr and BUN before and after treatment in two groups(P>0.05).UACR decreased significantly compared to base line in the two groups(P<0.05).There was no significant difference in variation of Scr,BUN and UACR between two groups before treatment,after1 month and 2 months treatment(P>0.05).5.The patients were divided into male and female groups.There was no significant difference in Scr and BUN in male group before treatment,after1 month and 2 months treatment(P>0.05).UACR decreased after treatment in both male and female groups.However,there was no significant difference in the variation of Scr.BUN and UACR between the subgroups before treatment,after1 month and 2 months treatment(P>0.05).6.Analysis of clinical indicators showed that the number of URBC decreased significantly compared with base line(P<0.05),and the level of serum albumin increased(P<0.05)during the 2-month follow-up.The number of WBC in peripheral blood after 1 and 2 months treatment was lower than that before treatment but still in normal range,and the variation was not statistically significant.7.No obvious adverse reactions occurred in all patients during the treatmentConclusion1.Kunxian capsule is effective in treating glomerulonephritis,especially in improving urinary protein.2.The shot-term efficacy of kunxian capsule on serum creatinine was not obvious.3.Gender and age are not the important factors influencing the effect of Kunxian capsule in glomerulonephritis4.Kunxian capsule is safe for short-term treatment,no obvious adverse reactions were found. |
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