Clinical Efficacy Of Huaiqihuang Granules Combined With Losartan In Treatment Of Primary Glomerulonephritis

ObjectiveTo investigate the clinical efficacy of Huaiqihuang granules combined with losartan in treatment of primary glomerulonephritis and to perform the safety observation, thus providing a new therapy and guidance for the clinical treatment of primary glomerular disease.Subjects and MethodsFifty-two patients with primary glomerulonephritis admitted to our hospital from April 2014 to January 2015 were collected. The eligible patients were aged between 18 and 65 years with serum creatinine of less than 350umol/l, blood urea nitrogen of less than 17mmol/l, blood pressure below 130/80 mmHg and 24-hour urine protein quantitation of ≤2.0g/24 h. Patients with proteinuria induced by secondary factors like lupus and purpura and patients with comorbid diabetes, cancer and connective tissue diseases, as well as those in taking hormone, cyclophosphamide, tripterygium glucoside tablets and other drugs, were excluded. Patients with serious underlying diseases and mental disorders were also excluded. According to the randomized controlled principle,eligible patients were randomly divided into experimental and control groups with 26 cases in each. Huaiqihuang granules and losartan were orally administrated simultaneously in the treatment group, while losartan alone was administrated in the control group. At 0, 4, 8 and 12 weeks after medication, patients in the experimental group and the control group were detected respectively in terms of 24-hour urine protein quantitation, serum creatinine, blood urea nitrogen, urinary sediment RBC, alanine aminotransferase, triglycerides, total cholesterol, blood glucose, potassium ions, sodium ions, RBC, WBC, neutrophil percentage, platelets and other indicators. The symptoms and signs of the experimental group and the control group were observed throughoutbefore and after treatment. The complete remission rate and the total effective rate were also observed in two groups after treatment. Complete remission(CR) represents the complete disappearance of symptoms and signs like edema; 24-hour urine protein quantitation was <0.2g/24h; urine microscopic examination showed that red blood cells disappeared; urinary sediment RBC and renal function were normal. Total effective rate=(Group CR cases+markedly effective cases+effective cases)/Number of patients in the corresponding group × 100%.Results1.Before treatment, the differences in age, gender and blood pressure were not statistically significant between two groups.2.After 12 weeks of treatment, the CR rate in the experimental group was 30.76%,while the CR rate in the control group was 11.53%, indicating that the CR rate in the experimental group was higher than that in the control group. The total effective rate was 96.15% in the experimental group while 69.23% in the control group, suggesting that the total effective rate in the experimental group was higher than that of the control group with a statistically significant difference(P=0.013).3.After 12 weeks of treatment, 24-hour urine protein quantitation was significantly decreased in both groups, and the difference in conditions before and after treatment was statistically significant in each group respectively(P<0.01). In addition, the decrease of 24-hour urine protein quantitation in the experimental treatment was significantly greater than that in the control group, suggesting a statistically significant difference(P=0.001).4.After 12 weeks of treatment, the serum creatinine levels were decreased in both the experimental group and the control group. The serum creatinine level in the experimental group was reduced after treatment compared with that before treatment,indicating a statistically significant difference(P<0.01). In the control group, the difference in serum creatinine level was not statistically significant before and after treatment(P=0.228). After treatment, the difference in serum creatinine decrease between the experimental group and the control group was statistically significant(P=0.03). The blood urea nitrogen levels were decreased in both the experimental group and the control group. The blood urea nitrogen in the experimental group was reduced after treatment compared with that before treatment, indicating a statistically significant difference(P<0.01). In the control group, the blood urea nitrogen was reduced aftertreatment compared with that before treatment, indicating a statistically significant difference(P=0.01). After treatment, blood urea nitrogen was more decreased the experimental group than that in the control group, suggesting a statistically significant difference(P=0.02).5.After 12 weeks of treatment, the urinary sediment RBC was decreased in both the experimental group and the control group. The difference in urinary sediment RBC levels before and after treatment was statistically significant in the experimental group and the control group respectively(P<0.01). After treatment, the difference in urinary sediment RBC decrease between the experimental group and the control group was statistically significant(P=0.002).6.During, before or after the medication, the differences in detection indicators,including alanine aminotransferase, potassium ions, sodium ions, WBC, RBC,neutrophil percentage, platelets, total cholesterol, triglycerides and blood pressure, were not statistically significant between the experimental group and the control group.7.It was not observed that Huaiqihuang granules had influence on indicators, such as alanine aminotransferase, potassium ions, sodium ions, WBC, RBC, neutrophil percentage, platelets, total cholesterol, triglycerides, blood pressure. No gastrointestinal adverse reactions were reported, either.ConclusionsThe efficacy of Huaiqihuang granules combined with losartan in the treatment of primary glomerulonephritis proves to be better than that of losartan alone. This therapy can significantly reduce the urinary protein and hematuresis and protect renal function without any significant adverse reactions.