| Objective To observe the long-term efficacy of professor Wang Yongjun in treatment of IgA nephropathy with syndrome differentiation therapy and the traditional Chinese medicine from the perspective of TCM patterns and renal pathology, thus to understand the advantage of Professor Wang’s method.Methods With retrospective analysis, to select cases of IgA nephropathy diagnosed by renal pathological biopsy in the Nephrology Department of the Guangxing affiliated hospital of Zhejiang Chinese medical university from January 2008 to December 2009, who were treated with Professor Wang’s therapy for more than 1 year. To collect the general conditions, results of renal biopsy, clinical manifestation, patterns of TCM, blood pressure, endpoint and laboratory indexing, such as urinary RBC count,24-hour urine protein, serum creatinine(Scr), glomerular filtration rate(GFR), blood uric acid(BUA), plasma albumin and hemoglobin. With application of SPSS 17.0 statistical software, to analyze the changes of clinical effect and laboratory indexing before the treatment and after the end of follow-up, from perspective learning on TCM patterns and renal pathological grading Lee.Results Firstly, in a total of 88 patients with IgA nephropathy,42 males(47.7%) and 46 females(52.3%) were met the inclusion criteria. The ratio of M-F was 1 to 1.1. The mean follow-up time was 63.77±21.37 months(range from 12 to 94 months). Secondly, after the treatment 40 cases were complete remission,17 were marked effect,15 were effective and 16 cases were invalid. The general effective rate was 81.82%. The declining of urinary RBC count and 24-hour urine protein and the ascending of plasma albumin and hemoglobin showed significant difference after the treatment(P<0.05), while the results of Scr,GFR and BUA had no significant difference(P>0.05). Thirdly,1 case of main endpoint events was measured as double Scr during the follow-up time. No case developed into the end stage renal disease (ESRD). Fourthly, the analysis of clinical effects showed that Liver-wind syndrome(90.00%)>the blood stasis syndrome(88.24%)> Wind-damp syndrome(80.95%)> Kidney-deficiency syndrome(77.50%) in TCM patterns and LeeⅡ(93.33%)>LeeⅢ(80.70%) >LeeⅣ(75.00%)in renal pathological grading. Finally, the urinary RBC count and 24-hour urine protein declined and the plasma albumin and hemoglobin ascended in the patterns of Kidney-deficiency, Wind-damp,blood-stasis and Liver-wind(P< 0.05). The hemoglobin glowed up in the pattern of Wind-damp and Kidney-deficiency (P<0.05).Conclusions As a whole, the total clinical effective rate of the IgA nephropathy, treated by Chinese medicine with application of professor Wang’s method, comes to81.28%. The urinary RBC count,24-hour urine protein, the plasma albumin and hemoglobin were improved. The urinary RBC count,24-hour urine protein and plasma albumin were all improved in different patterns. However, the variety of other indexes was different.For a long-term, it is quite effective to treat IgA Nephropathy with application of Professor Wang Yongjun’s syndrome differentiation therapy, which is significant to the clinic and practical application. |
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