| BackgroudIgA nephropathy(IgAN) is an immune-complex-mediated glomerulonephritis, defined immunohistologically by the presence of glomerular IgA deposition, which can accompany other immuno-complex or not. IgAN is a common form of primary glomemlonephritis in China, and the main cause of end-stage renal disease(ESRD). It is estimated that about 18.3% of patients with ESRD suffered from IgAN. Recently, it is still not clear for the etiology and pathogenesis of IgAN, so specific treatments for the disease is rare, while Chinese medicines have definite effects on it.ObjectiveTo observe clinical effects of Yiqizishen decoction and provide the basis for clinical treatment of IgAN by Chinese medicines.Methods1 Cases grouping40 patients with IgAN of both qi and yin deficiency confirmed by renal biopsy were randomly divided into experimental group(20 cases) and control group(20 cases) throuth random number table.2 TherapiesYiqizishen decoction, decocted by pharmacy uniformly, were taken orally by 20 sufferer in experimental group,1 dose per day,2 times a day, and continuously taken in 2 months. Dipyridamole were taken orally by 20 sufferer in control group during 2 months,50mg each time,3 times a day.3 Observation indexes3.1 Safety observation indexes:blood routine examination, heart and liver function tests, and possible adverse reactions.3.2 Curative effect observation indexes:①Tcm clinical symptoms;②aboratory observation indexes:creatinine clearance rate(Ccr), serum creatinine(Scr), blood urea nitrogen(BUN), 24-hour urinary protein quantitative, urinary routine examination.The observation indexes in experimental group and control group were recorded both before and after treatment.4 Statistical analysisMeasurement data using mean±standard deviation(x±s), intra-group comparison with paired t test, intergroup comparison with independent-samples t test, enumeration data with x2 test, ranked data with rank sum test, all data processing was used by SPSS13.0. P<0.05 indicated that the difference was statistically significant.Results1 Baseline comparisonBefore treatment, there was no statistical significance between experimental group and control group in terms of sex, age, course of disease, tcm clinical symptoms, laboratory-related examination(P<0.05), which indicated that 2 groups were comparable.40 patients had no falling through a course observation.2 Comparison between 2 groups after treatment in clinical effectThe total effect rate of experimental group was 85%, while that of control froup was 70 %. there was statistical significance between 2 gtoups(P<0.05), the former was better than the latter.3 Comparison between 2 groups after treatment in effect of tcm syndromesThe total effect rate of experimental group was 90%, while that of control froup was 60 %. there was statistical significance between 2 groups(P<0.05), the former was better than the latter.4 Comparison between 2 groups before and after treatment in single symptom scores of tcmComparison in experimental group before and after treatment, there was statistical significance in terms of Shaoqifali, susceptible to colds, edema, Shouzuxinre, Kouganyanzao, low back pain(P<0.01 or P<0.05), which showed that these symptoms were obviously improved in experimental group. Comparison in control group before and after treatment, there was statistical significance in terms of edema, Shouzuxinre, Kouganyanzao(P<0.05), which showed that these symptoms were obviously improved in control group. Comparison between 2 groups after treatment, there was statistical significance in terms of Shaoqifali, Shouzuxinre(P<0.05), which showed that experimental group was better than control group in improvement of these symptoms.5 Comparison between 2 groups before and after treatment in total scores of tcm symptomsThere was statistical significance before and after treatment of 2 groups in improvement of tcm symptoms(P<0.01), which showed that tcm symptoms of patients in 2 groups were obviously improved. There was statistical significance between 2 groups after treatment in improvement of tcm symptoms(P<0.05), which showed that experimental group was better than control group in improvement of tcm symptoms.6 Comparison between 2 groups before and after treatment in urine erythrocyte and proteinThere was statistical significance before and after treatment of 2 groups in decrease of urine erythrocyte and protein(P<0.01 or P<0.05), which showed that all drugs of 2 groups could decrease urine erythrocyte and protein. There was statistical significance between 2 groups after treatment in decrease of urine erythrocyte (P<0.05), which showed that experimental group was better than control group in decrease of urine erythrocyte.7 Comparison between 2 groups before and after treatment in 24-hour urinary protein quantitativeThere was statistical significance before and after treatment of 2 groups in 24-hour urinary protein quantitative(P<0.01), which showed that all drugs of 2 groups could decrease urine protein. There was statistical significance between 2 groups after treatment in decrease of urine protein(P<0.05), which showed that experimental group was better than control group in decrease of urine protein.8 Comparison between 2 groups before and after treatment in Scr, BUN, CcrThere was no statistical significance before and after treatment of control groups in Scr, BUN, Ccr(P>0.05), which showed that the drug of control group had no significant effect on Scr, BUN, Ccr. There was no statistical significance before and after treatment of experimental groups in Scr,BUN(P>0.05), which showed that the drug of experimental group had no significant effect on Scr,BUN. There was statistical significance before and after treatment of experimental groups in Ccr (P<0.05), which showed that the drug of experimental group could increase Ccr.9 Safety analysisDuring the study, patients in 2 groups had no heart and liver dysfunction and obvious harmful symptoms and signs. Accordingly, it is safe to perform the study and take Yiqizishen decoction orally.Conclusion1 Yiqizishen decoction had greatly positive effects on treating IgAN of both qi and yin deficiency.2 Yiqizishen decoction could obviously improve tcm symptoms of patients with IgAN of both qi and yin deficiency.3 Yiqizishen decoction could decrease urine erythrocyte and protein of patients with IgAN of both qi and yin deficiency.4 Yiqizishen decoction could improve renal fuction at early stage in treating IgAN of both qi and yin deficiency. |
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