| Objective: The clinical features of NS are Heave Proteinuria, hypoproteinemia, hyperlipemia and edema. NS include three types: PNS, secondary nephrotic syndrome and hereditary nephrotic syndrome. Diagnosis of PNS should exclude secondary and genetic factors. Treatment of PNS consist of relatively complex protocals. The primary treatment of western medicine is to inhibit immune and inflammatory response. Glucocorticoid is the first choice, but long-term use of glucocorticoid, some patients will experience hormone-receptor-positive, hormone resistance, and other serious side effects, especially in the stage of maintenance dose, leading to exacerbations or recurrence. The features of Traditional Chinese Medicine are overall concept and dialectic treatment, and it still holds an important position in Modern Medicine. Clinical observation shows that the dialectical application of traditional Chinese medicine in different stages of long-term hormone treatment, have acquired synergism and attenuation effect.In our study, CHOL, TG, LDL, HDL, ALB, 24h-UTP, TCM syndrome scorings, the total efficiency rate, the incidence of side effects and recurrence rate were observation indexes. To observe the changes of blood lipid, ALB, 24h-UTP, TCM syndrome scorings before and after treatment of two groups. And calculated he total efficiency rate、the incidence of side effects, recurrence rate.Methods: In this study, there were 50 PNS patients. They were volunteered and collected from the patients of inpatient and outpatient in Hebei Province Chinese medicine hospital. All patients were randomly divided into two groups: twenty-five cases in test group and twenty-five cases in control group. The control group was treated with glucocorticoid 1mg/(kg·d) in the morning. The maximum daily amount of glucocorticoid was less than 60 mg, after 8-12 weeks started gradual reduction, and usually every 2-3 weeks reduced the original dose of 10%. When the dose was 20mg/d reducing slowly. When reduced to 10mg/d, maintaining more than half a year. According to the change of condition, choosing immune-suppressive. Giving the drugs of diuretic, antihypertensive, anticoagulation, lipid-lowering and so on. On the basis, the patients of test group were treated with dialectical application of traditional Chinese medicine at different stages of the use of glucocorticoid.Results:1 Comparison of indexes of blood lipidBefore treatment, blood lipid indexes of two groups were no significant difference(P>0.05). The comparison of two groups before and after treatment, CHOL, TG, LDL were significantly decreased(P<0.05), HDL were significantly increased(P<0.05). The test group compared with the control group after treatment, CHOL, TG, LDL were significantly decreased(P<0.05), HDL had no significant difference(P>0.05).2 Comparison of ALBBefore treatment, the ALB of two groups were no significant difference(P>0.05). The comparison of two groups before and after treatment, ALB increased significantly(P<0.05). The test group compared with the control group after treatment, the test group was significantly better than the control group(P<0.05).3 Comparison of 24h-UTPBefore treatment, the 24h-UTP of two groups were no significant difference(P>0.05). The comparison of two groups before and after treatment, 24h-UTP decreased significantly(P<0.05). The test group compared with the control group after treatment, the test group was significantly better than the control group(P<0.05).4 Comparison of TCM syndrome scoringsBefore treatment, the TCM syndrome scorings of two groups were no significant difference(P>0.05). The comparison of two groups before and after treatment, TCM syndrome scorings decreased significantly(P<0.05). The test group compared with the control group after treatment, the test group was significantly better than the control group(P<0.05).5 Comparison of total effective rateIn test group, the total effective rate was 91.67%. In control group, the total efficiency was 72.73%. After treatment, the total effective rate of two groups were significant difference(P<0.05).6 Comparison of the incidence of side effectsIn two groups, acne, facial flushing, insomnia, and gastrointestinal reaction were significant difference(P<0.05), that showed the incidence of those side effects in test group lower than the control group. There was no significant difference between Cushing syndrome and osteoporosis.7 Comparison of the recurrence rateIn test group, the recurrent rate was 13.64%. In control group, the recurrent rate was 31.25%. The recurrent rate of two groups were significant difference(P<0.05).Conclusion:The application of traditional Chinese medicine in different stages can obviously improve the disorder of lipid, increase ALB, reduce 24h-UTP, improve clinical efficacy, reduce the incidence of side effects and the recurrence rate in patients with PNS. |
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