| Objective:The clinical data of 131 IMN patients were retrospectively analyzed to observe the clinical efficacy and safety of TCM syndrome differentiation and treatment combined with western medicine.The traditional Chinese medicine inheritance platform system was used to explore the regularity of the prescription drug in the idiopathic membranous nephropathy group,and to provide an effective treatment plan for integrated traditional Chinese and western medicine for the clinical treatment of idiopathic membranous nephropathy.Methods:1.A retrospective analysis was used to collect the clinical data of 131 patients diagnosed as IMN from January 2008 to January 2017 in Heilongjiang Provincial Hospital of TCM,before and after the treatment,in the first month,March,and June.Quantitative changes of urinary protein were observed at September and December of the 24 th month.Observed changes in the therapeutic indices of plasma albumin,total protein,serum creatinine,total cholesterol,etc.before and after treatment.The remission rate was observed in the 6th and 12 th months of treatment.Adverse reaction events occurred.The correlation between rate,TCM syndrome type and pathological staging,etc.SPSS 23.0 was used to establish a database and related statistical analysis was performed.2.Using the traditional Chinese medicine inheritance platform system(V2.5),to analyze the prescriptions of traditional Chinese medicine for the treatment of IMN based on syndrome differentiation.Results:1.The 24-hour urinary protein quantification before and after the first month,the third month,the third month,the sixth month,the sixth month,the second month,the second month,and the second month of the month after the treatment was compared: the first month of treatment,March,June,and September.Decreased in December compared with before treatment,the difference was statistically significant(P<0.01).Among them,the most significant decline occurred in the sixth month of treatment.2.In the 6th month of treatment,plasma total protein and plasma albumin increased compared with that before treatment,and the difference was statistically significant(P<0.01).In the 6th month of treatment,total cholesterol and low-density lipoprotein decreased compared with those before treatment,and the difference was statistically significant(P<0.01).There was no significant difference in serum creatinine,triglyceride,high-density lipoprotein,urea nitrogen,uric acid and globulin between the two groups before treatment(P>0.05).In the 6th and 12 th months of treatment,the total clinical remission rate was91.60% and 94.20%,respectively.3.After 6 months of treatment,the TCM syndromes were significantly improved,and the difference was statistically significant(P<0.01).4.Among the commonly used treatment programs for the second renal department of the Heilongjiang Provincial Hospital of TCM,the TCM Treatment System + Hormone +Tripterygium Glycosides Tablets is the most commonly used treatment program,and the total remission rate is higher than other treatment options..5.In the course of treatment,adverse events occurred in 21 cases,accounting for16.03% of the total.6.The pathological stages were mainly stage I and stage II.There was no significant difference between pathological stage and age and TCM syndrome type(P>0.05).In the pathological description,the incidence of renal interstitial focal inflammatory cell infiltration in the age range of 60-75 years old was higher than other age groups,and the difference was statistically significant(P<0.05).7.IMN syndrome types mostly deficiency of spleen and kidney qi,damp heat syndrome,blood stasis syndrome,the use of traditional Chinese medicine inheritance platform system after the screening of the prescription analysis found that the frequency of drug selection in medicine from high to low are: > Codonopsis pilosula> Yam herbs>Hedyotis diffusa> Mulberry seedling> Scutellaria barbata> Rosa laevigata> Smilax glabra>Coix Seed> Glycyrrhiza uralensis> Scorpion> Achyranthes bidentata,etc.;The types of drugs involved are: Tonic,heat-clearing agent,and Astringent medicine,diuretic water seepage medicine,blood circulation and phlegm medicine.Extract and evolve relevant drug pairs,core combinations,and new prescriptions.Conclusion:1.The combination of TCM syndrome differentiation and treatment with Western medicine has significant effects in reducing albuminuria,increasing plasma albumin and total protein,and improving TCM syndromes in patients with idiopathic membranous nephropathy.2.Among the commonly used treatment programs for the second renal department of the Heilongjiang Provincial Hospital of TCM,Chinese medicine has the most use of treatment based on syndrome differentiation + hormone + Tripterygium wilfordii,compared with other treatment options,it has the best effect and is worthy of extensive clinical application.3.IMN common Chinese medicine syndrome mostly spleen and kidney deficiency of Qi,hot and humid,blood stasis as the standard,treatment with kidney and spleen,heat and dampness,blood circulation.By using the traditional Chinese medicine inheritance platform system,the core medicine,high-frequency drug pairs and new prescriptions for treating IMN can be analyzed,which can provide theoretical guidance for the treatment of IMN by TCM syndrome differentiation. |
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