Clinical Study On Jianpi Wenshen Huayu Lishi Combined With Moxibustion For External Treatment Of Nephrotic Syndrome Combined With Hypothyroidism

Objective:Through the kidney and blood method combined moxibustion treatment of nephrotic syndrome with wet hypothyroidism combined clinical research,observation of TCM symptom score before and after treatment,laboratory indicators: 24 hours urinary protein,serum albumin,quantitative blood lipid(triglyceride,total cholesterol),and thyroid function(free thyroxine,thyroid stimulating hormone)improvement etc to study the kidney and blood lishi party with moxibustion therapy the clinical efficacy of nephrotic syndrome with hypothyroidism,At the same time to explore the diagnosis and treatment in treatment group after 24 hours urinary protein,serum albumin,quantitative blood lipid(triglyceride,total cholesterol),and thyroid function(free thyroxine,thyroid stimulating hormone),and objective for the internal and external treatment of traditional Chinese medicine treatment of nephrotic syndrome with hypothyroidism to provide theoretical support and clinical basis.Methods:60 cases of nephrotic syndrome with hypothyroidism admitted to the nephrology department of the affiliated hospital of jiangxi university of traditional Chinese medicine from December 2016 to October2018 were collected,and they met the diagnostic criteria of TCM syndrome of spleen-kidney Yang deficiency and blood stasis syndrome.All patients were randomly divided into treatment group and control group,with 30 cases in each group.The control group was given oral treatment ofglucocorticoid(prednisone acetate tablets)and levothyroxine sodium tablets,and other general symptomatic treatment.On this basis,the treatment group was treated with internal administration of invigorating spleen,warming kidney,removing blood stasis and promoting dampness,and external treatment with moxibustion.Both groups were treated for 8 weeks and 2 courses.The TCM syndrome score of patients was evaluated by guiding principles for clinical research of new drugs in China.(1)compare the24-hour urine protein quantification,serum albumin,blood lipids(triglycerides,total cholesterol),thyroid function(free thyroxine,thyrotropin),total score of TCM symptoms and clinical efficacy between the two groups before and after treatment;(2)Pearson or spearman correlation analysis was used to explore the relationship between urinary protein quantification,serum albumin,blood lipids(triglycerides,total cholesterol)and thyroid function(free thyroxine,thyrotropin)in the treatment group 24 hours after treatment.Results:1.The total effective rate of the treatment group was 83.33%,significantly better than that of the control group(60.00%,P<0.05).2.The total scores of TCM syndromes in both groups were significantly decreased before and after treatment,and the treatment group was superior to the control group(P<0.05);3.After treatment,the 24-hour urine protein quantification,blood lipids(total cholesterol,triglycerides)and free thyroxine(TSH)of the two groups were significantly decreased,and the reduction rate of the treatment group was better than that of the control group,with significant differences(P<0.05).Serum albumin and thyrotropin(FT4)were significantly increased in the two groups,and the elevation in the treatment group was higher than that in the control group,with significant differences(P<0.05).4.Serum albumin in the treatment group was positively correlated with FT4(r2=0.606,P<0.05),and negatively correlated with TSH(r2=0.314,P<0.05).Serum lipids(total cholesterol,triglycerides)and 24-hour urine protein were negatively correlated with FT4(r2=0.128,P<0.05).R2= 0.681,P < 0.05;R2 =0.701,P<0.05),positively correlated with TSH(r2=0.155,P<0.05).R2 = 0.219,P < 0.05;R2 =0.287,P<0.05).Conclusion:Urinary protein quantification,serum albumin,blood lipids(total cholesterol,triglyceride)and thyroid function were correlated in patients with nephrotic syndrome 24 hours after treatment.The kidney and blood lishi method that moxibustion treatment for nephrotic syndrome with hypothyroidism spleen kidney Yang deficiency type,water stasis mutual junction patients have increased serum albumin,FT4,reduce the 24 hours urinary protein,blood lipid(total cholesterol,triglycerides)quantitative,TSH and curative effect is superior to conventional western medicine treatment,is worth popularizing in clinical.