Objective: To explore the efficacy and safety of Yishen Huashi Granule in the treatment of Idiopathic Membrane Nephropathy(IMN)with Spleen Deficiency and Dampness,and to provide medication guidance for clinical treatment of IMN.Methods:Select IMN patients who meet the standard,and randomly divide them into control group and test group.The patients in both groups were treated with basic western medicine and tacrolimus capsules.The control group was added with valsartan capsule,and the test group was added with Yishen Huashi Granules for a period of 6 months.Recorded the 24-hour urine protein content(24h UTP),serum albumin(ALB),Triacylglycerol(TG),cholesterol(CHOL),serum anti phospholipase A2 receptor(PLA2R)antibody,serum creatinine(SCR),blood urea nitrogen(BUN),TCM syndrome score,safety indicators and adverse reactions were analyzed statistically to evaluate the efficacy and safety of Yishen Huashi Granule in treating IMN patients with spleen deficiency and dampness syndrome.Result:1.A total of 59 patients completed the study,30 in the test group and29 in the control group.The general data(gender,age,and distribution of pathological stages)of the two groups were not significantly different(P>0.05)and were comparable.2.There was no significant difference between the two groups in 24 h UTP,ALB,SCR,BUN,TG,CHOL,and serum PLA2 R antibody(P>0.05).After 6months of treatment,the levels of 24 h UTP,SCR,TG,CHOL and serum anti-PLA2 R antibody were significantly lower than those before treatment(P<0.05).The reduction of 24 h UTP and serum anti-PLA2 R antibody level in the test group was higher than that in the control group(P<0.05).The ALB of the two groups was higher than before(P < 0.01),and the effect of the experimental group was better than that of the control group(P<0.05).There was no statistically significant difference between the two groups in BUN before and after treatment(P>0.05).3.There was no significant difference in TCM syndrome score between the two groups before treatment(P>0.05),but both decreased significantly after treatment(P<0.01),and the decline in the test group was more significant(P<0.01).In terms of curative effect of TCM syndrome,the total effective rate of the test group and the control group were 93.33% and 72.41%respectively,and the effect of the test group was better(P<0.05).In terms of clinical disease efficacy,the total effective rates of the test group and the control group were 90.00% and 75.86% respectively,and the test group was superior to the control group(P<0.05).4.The incidence of adverse reactions was 3.33% in the test group and6.90% in the control group.There was no significant difference between the two groups(P>0.05).5.The level of anti-PLA2 R antibody in patients before treatment was positively correlated with 24 h UTP and negatively correlated with ALB(P<0.05).There was no correlation between 24 h UTP,ALB and PLA2 R antibody levels in patients after treatment(P>0.05).Conclusion: Yishen Huashi Granule can effectively reduce the level of urine protein and anti-PLA2 R antibody in IMN patients with spleen-deficiency and dampness-enriched syndrome,improve ALB,improve blood lipid disorder,and protect renal function.It has excellent clinical efficacy and high safety,and is worthy of clinical application and promotion.The serum PLA2 R antibody is an effective indicator to evaluate the severity of patients before immunosuppressive treatment. |