Clinical Research On The Effect Of The Treatment Of Zhibai Dihuang Decoction On Syndrome Of Endogenous Heat Due To Yin Deficiency Of Lupus Nephritis

Objective: To evaluate the clinical efficacy and safety of Zhibai Dihuang Decoction combined with western medicine in the treatment of LN,by observing the effect of Zhibai Dihuang Decoction on yin deficiency syndrome of lupus nephritis(LN)patients with laboratory indexes,SLEDAI score,TCM syndrome score,to provide a basis for the method to explore the TCM treatment of LN.Methods: From January 1,2015 to October 31,2016 in the First Affiliated Hospital of Guangxi College of traditional Chinese Medicine Department of rheumatism,Department of nephropathy outpatient and inpatient treatment of patients diagnosed with lupus nephritis and TCM syndrome type of yin deficiency type of 60 patients were randomly divided into treatment group and control group of 30 cases.The patients in control group were treated with a hormone(prednisone acetate 1mg / kg / d,a total of 12 weeks,and then regular reduction)and cyclophosphamide;The patients in treatment group on the basis of the control group dialectical internal treatment Zhibai Dihuang Decoction addition and subtraction.The total course of treatment was 3 months.To observe two groups of patients before and after treatment of TCM syndrome score,SLEDAI score,24 hours urinary protein,Scr,BUN,WBC,HGB,PLT,ESR and complement(C3;C4),anti-ds-DNA and the incidence of adverse reactions.Results:(1)Comparison of the efficacy of two groups of patients,the total effective rate was 82.14% in the treatment group and 75.00% in the controlgroup,The difference was statistically significant(P<0.05).(2)Compared with two groups of patients with traditional Chinese medicine syndrome curative effect,the treatment group TCM syndrome total effective rate was 89.29% better than the control group 78.57%,there was a statistically significant difference(P<0.05).(3)The scores of TCM syndromes and SLEDAI were compared between the two groups,after treatment,the scores of both groups were reduced(P<0.05).The improvement of the treatment group was better than that of the control group(P<0.05).(4)Compared with two groups of patients with blood routine,renal function,ESR,after treatment,the HGB,PLT,WBC,Scr,BUN,ESR were better than before treatment(P<0.05).The improvement of the treatment group was better than that of the control group(P<0.05).(5)Compared with immune indexes between the two groups,after treatment,complement C3 levels were significantly increased(P<0.05),the improvement of the treatment group was better than that of the control group(P<0.05);after treatment,the anti-ds-DNA of the two groups decreased(P<0.05),the improvement of the treatment group was better than that of the control group(P<0.05)However,there was no significant change in complement C4 in the two groups(P>0.05).(6)After treatment,compared with the two groups,the 24 hours urine protein of the two groups were significantly reduced(P<0.05).And the treatment group was superior to the control group(P<0.05).(7)compared with the incidence of adverse reactions in both groups,the adverse response rate(7.14%)(1 case of irregular menstruation and 1 case of acne)in the treatment group was lower than that in the control group(28.57%)(2 cases of acne and gastrointestinal discomfort,Irregular menstruation in 4 cases,infection in 1 case)in the irregular menstruation,infection and acne.The difference was statistically significant(P<0.05).Conclusion:In addition to the combination of cyclophosphamide combinedwith cyclophosphamide treatment with Zhibai Dihuang Decoction can improve the efficacy of patients with lupus nephritis,it also can improve anemia,renal function,Yin deficiency heat syndrome,and can reduce inflammation indicators,reduce lupus activity.