| Objective: to retrospectively analyze the clinical data and laboratory indexes of flavored Peach Chen Membrane Kidney Decoction combined with hormone and cyclophosphamide in the treatment of idiopathic membranous nephropathy(IMN)with hypercoagulable state,and to evaluate the therapeutic effect of flavored Peach Chen Membrane Kidney Decoction on hypercoagulable state and IMN,so as to provide TCM syndrome differentiation and treatment ideas for better treatment of IMN and concomitant hypercoagulable state.Methods: from October 2020 to October 2022,62 patients with phlegm and blood stasis syndrome diagnosed as idiopathic membranous nephropathy with hypercoagulable state were collected from the nephropathy clinic and nephropathy ward of the affiliated Hospital of Liaoning University of traditional Chinese Medicine.62 cases were selected and divided into treatment group and control group according to whether they took traditional Chinese medicine decoction or not.the control group was given western medicine supportive treatment and hormone + cyclophosphamide regimen.The treatment group was treated with flavored Peach Chen Membrane Kidney Decoction orally on the basis of the control group.The observation time was 6 months(coagulation function and D-dimer index were observed for 1 month).The clinical data and laboratory indexes were collected: 24-hour urinary protein quantity(24h-Upr),albumin(ALB),prothrombin time(PT),PT activity(PT%),international standardized ratio(INR),activated partial thromboplastin time(APTT).The changes of thrombin time(TT),fibrinogen(FBG),D-dimer(D-Di),platelet count(PLT),thrombocrit(PCT),mean platelet volume(MPV),platelet distribution width(PDW),triglyceride(TG),serum total cholesterol(CHOL),and serum creatinine(Scr)and blood urea nitrogen(BUN)were observed.The safety indexes such as white blood cell(WBC),hemoglobin(HGB),glutamic pyruvic transaminase(ALT)and glutamic oxaloacetic transaminase(AST)were statistically analyzed by SPSS25.0 software.Results:1.The analysis of the data of the two groups before treatment was P > 0.05,there was no difference,so it could be compared.2.Symptom scores of the two groups: there were significant differences in symptom scores between the two groups after treatment for 3 months and 6 months(P < 0.05).The symptom improvement of the treatment group was better than that of the control group,and with the increase of treatment time,the degree of improvement became more obvious.3.Efficacy comparison3.1 TCM efficacy of the two groups: the effective rate of the treatment group was 87.5%,while that of the control group was 70%.There was a significant difference between the two groups(P < 0.05).3.2 Western medicine efficacy of the two groups: the remission rate of the treatment group was 90.63%,while that of the control group was 70%.There was a significant difference between the two groups(P < 0.05).4.Comparison of laboratory indexes4.1 the blood coagulation function,D-dimer and platelets of the two groups were improved after treatment,and the degree of improvement between the two groups was statistically significant(P < 0.05).The curative effect of the treatment group was better than that of the control group.4.2 Urinary protein quantity: after treatment,the 24h-Upr of the two groups decreased,and there was a difference between the two groups,and the curative effect of the treatment group was higher than that of the control group(P < 0.05)..4.3 Albumin: the ALB of the two groups increased after treatment,and with the increase of treatment time,the difference between the two groups was gradually significant,and the curative effect of the treatment group was higher than that of the control group(P < 0.05).4.4 the triglyceride and cholesterol of the two groups decreased after treatment,and the curative effect of the treatment group was better than that of the control group,and there was significant difference between the two groups(P < 0.05).4.5 there was no significant difference in leukocyte,hemoglobin,serum creatinine,urea nitrogen,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase between the two groups(P > 0.05,P > 0.05).Conclusion:flavored Peach Chen Membrane Kidney Decoction combined with hormone and cyclophosphamide in the treatment of idiopathic membranous nephropathy can improve the clinical symptoms of patients with idiopathic membranous nephropathy,increase the level of albumin,reduce urinary protein,reduce cholesterol and triglyceride,and improve the state of hypercoagulability.it has no adverse effect on liver and kidney function and blood routine,and has a good and safe clinical effect. |
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