Clinical Observation Of Professor Wang Tieliang’s Application Of Nourishing Qi Nourishing Yin,Clearing Heat And Removing Dampness In The Treatment Of Idiopathic Membranous Nephropathy

Objective : Based on Professor Wang Tieliang’s experience in treating idiopathic membranous nephropathy,this paper proposes the Chinese medicine decoction for nourishing qi,nourishing yin,clearing heat and removing dampness combined with tripterygium wilfordii polyglycosides as the TCM treatment plan,and hormone combined with tripterygium polyglycosides as the control group.Program,through the clinical efficacy to prove the effectiveness and safety of Professor Wang Tieliang dialectical treatment of IMN.Methods:Summarize Professor Wang Tieliang’s academic thoughts on the treatment of IMN through theoretical study and clinical consultation,and prove the effectiveness and safety of Wang Tie-liang’s TCM dialectical treatment of IMN through the observation of the efficacy of clinical research.A total of 96 patients who were diagnosed with IMN by renal biopsy in the outpatient department of nephrology of Professor Wang Tieliang from June2018 to June 2021 were selected for the clinical study.Among them,48 patients in the group of traditional Chinese medicine combined with tripterygium wilfordii polyglycosides(traditional Chinese medicine+GTW),methylprednisolone tablets Combined with tripterygium wilfordii polyglycosides(MP+GTW)group,48 cases were given basic treatment,and a total of 6 months were observed.The effective rate,24-hour urine protein(UTP),serum albumin(ALB),serum creatinine(Scr),total cholesterol(TC),24-hour urine protein(UTP),serum creatinine(Scr),total cholesterol(TC),The changes of laboratory indicators such as triglyceride(TG)and TCM syndrome scores were evaluated according to the proposed evaluation criteria to evaluate the effectiveness and safety of the two groups of treatment programs.Results : 1.A more systematic summary of Professor Wang Tieliang’s academic thoughts on the treatment of IMN :(1)Pathogenesis is always based on deficiency and deficiency,deficiency of spleen and kidney is based,and pathological factors such as water,dampness,heat,blood stasis are mixed as the standard;(2)Pay attention to the pathogenesis of dampness in IMN The role of pathogenesis;(3)Micro-dialectics,introducing the theory of "Kidney Mysterious Palace";(4)According to the pathological transformation of the patient’s specimens,he advocates staged and staged treatment;2.A total of 45 patients in the traditional Chinese medicine + GTW group completed6-month follow-up,a total of 46 patients in the MP + GTW group completed the 6-month follow-up,and 91 patients in the two groups actually completed the follow-up,including 54 males,accounting for 59.3%,and 37 females.It accounted for 40.7%,and the male to female ratio was 1.46:1.After 6 months of treatment,the total effective rate in the traditional Chinese medicine + GTW group was 91.11%,which was significantly higher than that in the MP + GTW group,69.57%,and the difference was statistically significant(P < 0.05).UTP),serum albumin(ALB),total cholesterol(TC),triglyceride(TG),serum creatinine(Scr),and TCM syndrome scores,there was no significant difference(P>0.05).One month later,the traditional Chinese medicine + GTW group was better than the MP + GTW control group in terms of UTP,ALB,Scr,TC,TG,and improvement of TCM syndrome scores,and the difference was statistically significant(P<0.05);the traditional Chinese medicine + GTW group The incidence of adverse reactions and adverse events in the MP+TGW group was6.7% and 10.9%,respectively,and the adverse reactions in the traditional Chinese medicine+GTW group were few and small;the difference was statistically significant(P<0.05).No serious pathological changes were found in routine,urine routine,liver function,and renal function tests.Conclusion:1.For IMN with deficiency of qi and yin and internal accumulation of damp-heat,both Chinese medicine + GTW group and MP + GTW group can effectively reduce proteinuria and relieve the patient’s condition.2.The traditional Chinese medicine + GTW group can reduce proteinuria earlier.Compared with the MP + GTW group,it has the advantages of less side effects,fewer and fewer complications,and the patients are easy to tolerate and have better clinical efficacy.feasibility and safety.