| Objective:To study the efficacy and safety of Professor Zhang Peiqing's experience in the treatment of Ig A.Based on the auxiliary platform system of traditional Chinese medicine inheritance,the law of prescription and medication of Professor Zhang Peiqing was deeply explored to provide a more effective diagnosis and treatment scheme for clinical treatment of Ig AN.Methods:1.The clinical data of 83 patients with primary Ig A nephropathy diagnosed by the second Department of nephrology in our hospital from January 2010 to January 2020 were collected and analyzed retrospectively.The changes of 24-hour urine protein quantity and urine red blood cell count(0,1,3,6,9,12 months after treatment)were observed.The glomerular filtration rate(EGFR),serum creatinine(CR),urea nitrogen(BUN),white egg were observed before and after treatment ALB and other therapeutic effects.2.Based on the auxiliary platform of traditional Chinese medicine inheritance system,analyze the law of prescription and medication of Professor Zhang Peiqing's TCM syndrome differentiation and treatment of Ig AN.Results:1.Comparison of laboratory efficacy indicators:1.1 the 24-hour urine protein quantity and urine red blood cell count of six treatment time points(treatment1,3,6,9,12months)showed a gradual downward trend;the 24-hour urine protein quantity and urine red blood cell count of each time point after treatment decreased compared with that before treatment(P < 0.01).1.2 the total number of red blood cells,hemoglobin,glomerular filtration rate,total protein and albumin after treatment were significantly higher than those before treatment(P < 0.01);globulin after treatment was slightly higher than that before treatment(P < 0.05);serum creatinine,low-density lipoprotein,total cholesterol and triglyceride after treatment were significantly lower than those before treatment(P < 0.01);urea nitrogen,uric acid and dioxygen After treatment,there was no significant difference between the two groups(P > 0.05);2.Analysis of pathological results: 2.1 comparison of pathological type distribution: in the pathological report and diagnosis statistics,focal hyperplastic Ig A was the most common in 28 cases(33.73%).2.2 correlation analysis between Oxford pathological classification and clinical data: 24-hour urinary protein may be related to s(segmental sclerosis)and t(renal interstitial fibrosis and tubular atrophy);urinaryRBC level may be related to m(mesangial cell increase);glomerular filtration rate level may be related to t(renal interstitial fibrosis and tubular atrophy)There is a certain relationship between serum uric acid and S(segmental sclerosis).3.Comparison of clinical efficacy before and after treatment: the total effective rate of clinical remission in the sixth month was 90.36%,and the total effective rate in the twelfth month was 92.86%.The clinical symptom score decreased significantly after treatment(P < 0.05).4.Comparison of therapeutic effects: there are 10 therapeutic schemes in total,"traditional Chinese medicine +hormone" is the most commonly used therapeutic scheme,followed by "traditional Chinese medicine + hormone + Tripterygium wilfordii".The total effective rate of "traditional Chinese medicine + hormone" is the highest,"traditional Chinese medicine + hormone +Tripterygium wilfordii" is the highest.5.Incidence of adverse events: 10 cases,the incidence of adverse events was 12.04%.6.Using the system of traditional Chinese Medicine Inheritance assistant platform statistical analysis,it is found that the order of medication frequency from high to low is: Astragalus,dangshen,yam,Poria cocos,liquorice,wolfberry fruit,Smilax cocos,coix seed,Cornus officinalis,Hedyotis diffusa,Ligustrum lucidum,Rehmannia officinalis and so on,among which tonic drugs are the main.Further extraction and evolution of related drug groups,core combinations and new prescriptions.Conclusion:1.Using Professor Zhang Peiqing's experience to treat Ig AN has a certain effect in reducing proteinuria and hematuria,increasing plasma protein,protecting renal function and improving TCM symptoms.2.2.In the treatment scheme,the most effective one is "traditional Chinese medicine + hormone",and the most effective one is "traditional Chinese medicine + hormone + Tripterygium wilfordii".3.The correlation analysis of Oxford pathological classification indexes and clinical data showed that 24-hour urine protein quantity may be related to s and T;urine RBC level may be related to m;glomerular filtration rate level may be related to t;blood uric acid level may be related to s.4.Professor Zhang Peiqing treated Ig A nephropathy mainly by tonifying deficiency,supplemented by clearing heat,removing dampness and removing blood stasis;mainly by sweet taste,cold,liver and kidney meridians;the core drug group was dangshen Huangqin Huangqi Anemarrhena,etc. |
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