Clinical Observation Of Shengyang Yiwei Decoction In The Treatment Of Refractory Membranous Nephropathy

Objective:To observe the changes of proteinuria and liver and kidney function in patients with refractory membranous nephropathy by observing the changes of Shengyang Yiwei decoction,so as to determine the clinical efficacy and safety of Shengyang Yiwei decoction,and to explore the optimal treatment for refractory membranous nephropathy.Methods:From August 2020 to January 2021,30 patients with refractory membranous nephropathy were treated with Shengyang Yiwei Decoction for 12 weeks,The changes of laboratory related indicators and TCM syndromes before and after treatment were observed,and the data were statistically analyzed to evaluate the treatment effect.Results:1.Clinical efficacy: after 12 weeks of treatment,3 cases(10%)had complete remission,17 cases(56.7%)had partial remission and 10 cases(33.3%)had no remission.The total remission rate was 66.7%.The urinary protein level was significantly lower than that before treatment(P < 0.05);Plasma albumin was higher than that before treatment,the difference was statistically significant(P < 0.05);Total cholesterol,triglyceride,low-density lipoprotein,fibrinogen and D-2 polymer were significantly lower than those before treatment(P < 0.05);There were no significant differences in serum creatinine,alanine aminotransferase,aspartate aminotransferase,glutamyltranspeptidase,serum potassium ion and hemoglobin before and after treatment(P > 0.05);The ECG was normal.2.Symptom effect: after 12 weeks of treatment,5 cases(16.7%)were clinically cured,9 cases(30%)were markedly effective,12 cases(40.0%)were effective,and 4 cases(13.3%)were ineffective.The total effective rate was 86.7%.After treatment,the TCM syndromes were significantly improved compared with before treatment(P < 0.01).Conclusion:1.Modified Shengyang Yiwei decoction can significantly reduce 24-hour urinary protein,and has no abnormal effect on renal function.2.Shengyang Yiwei decoction can increase plasma albumin,anticoagulant and regulate lipid metabolism.3.Shengyang Yiwei decoction can significantly improve the clinical symptoms of RMN patients.