From Qi Water Treatment Of Idiopathic Membranous Nephropathy And Enzyme With Imn Urine Protein Heparan Correlation Research

Idiopathic membranous nephropathy (IMN) is an important pathological ty pe of glomerular disease, along with the popularization and application of the technology, the disease diagnosis rates were increased year by year. There is also a widespread concern about the IMN’s treatment. Western medicine treatment for the disease has certain experience, but safety and effectiveness of the use of immunosuppressive agents are still debatable. Mentors in the in-depth study of traditional Chinese medical theory, combi ned with clinical experience, argued that this disease mainly lies in the dis orders of Qi Xue and Shui, due to Qi deficiency, blood stasis and water s tagnation, he founded the Yiqi Huoxue Lishui method to treat the disease of idiopathic membranous nephropathy. The clinical study mainly discusse d the characteristics and advantages of Yiqi Huoxue Lishui methods in tre ating IMN.Heparanase is a new glucose nucleosides enzyme which received extensi ve attention in these years, it has many biological functions; some studies show that its expression may be associated with renal disease. In this ex perimental study, we paid attention to the correlation of the heparanase and the urinary protein in the idiopathic membranous nephropathy patient s, to lay the foundation for the further study of the herbal curative effect f or relief the urinary protein in the idiopathic membranous nephropathy pati ents.Part1:The effect of Yiqi Huoxue Lishui therapy for treating the dise ase of idiopathic membranous nephropathyObjective:As the guide of QiXueShui theories of TCM, we observed the effects of Yiqi Huoxue Lishui therapy for treating IMN.Methods:This study used a randomized, open, controlled clinical trials,60patients that conformed to the case inclusion criteria were randomly divi ded into experimental group (basic therapy+Yiqi Huoxue Lishui herbs) a nd control group (basic therapy+ACEI) according to the time sequence. We compared with two groups patients before and after treatment as wel l as among two groups of TCM efficacy, disease comprehensive curative effect, urinary protein and other related physical and biochemical index ch ange.Preliminary evaluation the effects of Yiqi Huoxue Lishui therapy for tr eating IMN. We used SPSS17.0to establish database and analyzed statis tically, that P value<0.05indicated the statistical significance.Results:1. Total efficacy analysis:The results of the60cases indicated:①TCM ef ficacy evaluation:the total effective rate of the experimental group was88.6%, the total effective rate of the control group was88%;②The western medicine comprehensive effectiveness evaluation:the total effective rate of the experimental group was85.7%, the total effective rate of the control group was80%;③The main physicochemical index:In the comparison wit hin groups, two groups of patients before and after the treatment, Scr, BU N, ALB,24hUpro and eGFR index changes had statistical significance(P <0.05); In the comparison between groups, two groups of patients befor e and after the treatment, all of the index changes had no statistical signif icance(P>0.05).2. The further analysis for the different groups according to the24hUpro. The group of the patients that24hUpro was less than3.5g:①TCM efficac y evaluation:the total effective rate of the experimental group was88.5%, the total effective rate of the control group was91.7%;②The western m edicine comprehensive effectiveness evaluation:the total effective rate of t he experimental group was80.7%, the total effective rate of the control gr oup was83.3%;③The main physicochemical index:In the comparison wit hin groups, two groups of patients before and after the treatment, Scr, BU N, ALB and eGFR index changes had statistical significance (P<0.05); I n the comparison between groups, two groups of patients before and after the treatment, all of the index changes had no statistical significance(P>0.05).The group of the patients that24hUpro was more than3.5g:①TCM effica cy evaluation:the total effective rate of the experimental group was88.9%, the total effective rate of the control group was84.6%;②The western me dicine comprehensive effectiveness evaluation:the total effective rate of th e experimental group was100%, the total effective rate of the control gro up was76.9%;③The main physicochemical index:In the comparison with in groups, two groups of patients before and after the treatment, Scr, ALB, 24hUpro and eGFR index changes had statistical significance (P<0.05); In the comparison between groups, two groups of patients before and a fter the treatment, all of the index changes had no statistical significance(P>0.05).3. Analysis for the related factors that influenced the curative effect:the in fluences differences of the renal function indexes (Scr, BUN),24hUpro,a lbumin, APTT and eGFR index for the effects had statistical significance (P<0.05); the influences differences of the course of treatment with the cl inical effects had statistical significance(P<0.05), as the treatment for4months and longer course, the curative effcts were more obvious; the inf luences differences of gender, age and pathologic stage for curative effect s did not have statistical significance (P>0.05).Conclusion:1. From the TCM theory analysis, TCM pathogenesis of idiopathic membr anous nephropathy is the disorders of Qi, blood and water, Qi deficiency with blood stasis and water stagnation may be the main type of the patho genesis.2. The Yiqi Huoxue Lishui therapy can relief the TCM symptoms, reduceth e urinary protein effectively for the patients of IMN, the clinical effects of Yiqi Huoxue Lishui therapy are almost as same as the functions of ACE I.3. The related factors, such as the renal function indexes (Scr, BUN),24hUpro, albumin, APTT and eGFR can produce certain influence on the clinical effect. The treatment course has certain influence on the curative effect, as the course is longer, the effect is more obvious. However, gen der, age and pathologic stage do not have certain influence on the clinical effect.Part2:The experimental research for the relationship between the h eparanase and the urinary protein of the idiopathic membranous nep hropathy patientsObjective:Detect and analyze the quantity of HPA in the blood of IMN p atience and healthy persons, found the relationships between the urinary protein and the heparanase, to lay the foundation for the further study of t he mechanism of herbal function for relieving the urinary protein of the pa tients of IMN.Methods:The study collected48patients, including33patients of idiopat hic membranous nephropathy,17patients were divided into clinical remissi on group (24hUpro was less than1.5g/24h) according to the24hUpro, also,16cases were divided into not mission group (24hUpro was more th an or equal to1.5g/24h). We also detected the HPA of15healthy per sons (24hUpro was less than200mg/24h).We used the human hepara nase (HPA) enzyme immunoassay (ELISA) kit for the determination of sample of heparanase level, and compared with the24hUpro of the cases. We used SPSS17.0to set up database for statistical analysis, The P val ue<0.05indicated a statistical significance.Results:The case study analysis showed that:①In the comparison betw een groups, the difference of the HPA quantity and the24hUpro in the re mission group, not remission group and healthy persons had statistical sig nificance (P<0.05). The difference through the HPA quantity with the24h Upro showed significant differences, in the not remission group, as the hig her level of24hUpro, the expression of heparanase level was higher than the remission one.②The group of data by Pearson correlation analysis s howed that, heparanase quantity and24hUpro had significant linear correl ation.③The SPSS17.0statistical software for data analysis simulated sim ulation chart of the linear regression equation of the heparanase quantity and24hUpro:Y=88.561+6.357X.Conclusion:This study indicates:In the analysis of the relationship betwe en the HPA quantity in the peripheral blood and the24hUpro in idiopathic membranous nephropathy patients, we find that the HPA quantity and the24hUpro have a significant linear correlation.