Clinical Observation Of Jiawei Qingxinlianziyin On Patients With Primary Nephrotic Syndrome Treated With Glucocorticoid

ObjectiveTo observe the clinical effect of Jiawei Qingxinlianziyin on patients with Primary nephrotic syndrome treated with standard protocol of glucocorticoids,and explore its mechanism.This study may provide a new way of treatment on PNS.Methods74 patients with PNS treated with standard protocol of glucocorticoids 6-8 weeks were enrolled from Provincial People's Hospital affiliated to Fujian University of TCM and Fuzhou General Hospital of Nanjing military command,from July 2015 to December 2016.Control group(n = 38)and TCM group(n = 36)were divided by method according to the random number table.According to the principles of high-dose,long-term,slow-decrement,patients of control group were given standard glucocorticoids therapy,they were treated by Oral prednisone starting dose of 1.0mg/(Kg-D)per morning,the maximum dosage is not more than 80mg/d.If they can't take it orally because of severe gastrointestinal edema or abnormal liver function,switch to the same does of prednisolone via intravenous untill symptom relieved.The pathological types of patients with membranous nephropathy(MN)or focal segmental glomerulosclerosis(FSGS)were treated with corticosteroids conbined with other immunosuppressive agents,the treatment was performed according to the consensus of experts on immunosuppression in Chinese adult nephrotic syndrome(2014).The experimental group based on the treatment in control group and treated with Jiawei Qingxinlianziyin per day.Two groups were treated for a course of two months.After the treatment,both of the two groups were evaluated that the 24hUV,SC(Eight clock in the morning),Incidence of upper respiratory tract infection and TCM symptom score of Qi Yin deficiency,ALB,TC,TG,LDL-C and Scr were related statistical analysis.Results1.Index of sex and age,deficiency of Qi and Yin Syndrome integral,related laboratory in two groups before treatment can be compared(P>0.05).2.TCM Qi Yin deficiency syndrome scores were significantly reduced after treatment for patients of two groups,but the TCM group was significantly better than the control group(P<0.01).3.After treatment,the ALB and SC of the two groups increased.TG,24hUV,TC,LDL-C were lower compared with before(P<0.05).There was no significant difference between the two groups after GC treatment(P>0.05).4.After treatment,the TCM group for ALB,TG,24hUV,SC and clinical outcome were better than those of the control group(P<0.05),and ALB was significantly better than that it(P<0.01).5.During the treatment,the incidence of upper respiratory tract infection in the TCM group was significantly less than control group(P<0.05).Conclusion1.Combined with standard glucocorticoids protocol,treated by Jiawei Qingxinlianziyin can improve Qi and yin deficiency syndrome score and clinical symptoms in the PNS patients with hormone withdrawal,and TCM clinical syndromes improved significantly better.2.Jiawei Qingxinlianziyin can significantly improve the ALB,TG,24hUV,SC by PNS with hormone withdrawal period of Qi and yin deficiency in patients.It's also better to promote the synthesis of serum albumin,regulate lipid metabolism,reduce proteinuria,improve the dysfunction of HPA axis system and the recovery of adrenocortical function.3.PNS patients with hormone withdrawal period prone is liable to infection of the upper respiratory tract,Jiawei Qingxinlianziyin can better prevent it and improve the clinical outcomes.4.Compared with the Jiawei Qingxinlianziyin and the standard hormone therapy,There are no signification difference of the decrease of TC,LDL-C and Scr.