| Objective:The traditional Chinese medicine treatment according to syndrome differentiation has a definite curative effect on membranous nephropathy.In order to play a guiding role in clinical practice,a research was carried out to verify the clinical efficacy and safety of Xintong Changluo method on patients with idiopathic membranous nephropathy with hypercoagulable state.Method:All cases were from patients who performed renal biopsy in the Department of Nephrology,the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from June 2014 to September 2019.The 120 patients with idiopathic membranous nephropathy with hypercoagulability who according to the standard of Inclusion and exclusion were divided into control group and treatment group.The control group was given western medicine routine treatment plan,and the treatment group was given the traditional Chinese medicine decoction of Xintong Changluo method on the basis of the control group(western medicine routine treatment plan).Each group was observed for 8 weeks(4weeks of D-D dimer).The clinical data of the patients were collected and then the clinical effect of the two groups before and after treatment and the improvement of TCM clinical symptoms were analyzed by TCM syndrome score and laboratory index:24 hours urine protein quantification,plasma total protein,plasma albumin,serum total cholesterol,triglyceride,low density lipoprotein,fibrinogen,D-D dimer,platelet count,prothrombin time,activated partial thromboplastin time.SPSS21.0 statistical software was used for data analysis,with P <0.05 was statistically significant.Results:1 Before treatment,the baseline data of the two groups of patients were analyzed by statistical method,and the difference was not statistically significant(P>0.05),indicating that the two groups of patients were comparable.2 According to the analysis of TCM symptoms of the two groups of patients,it is foundthat two groups patients are mainly with "edema disease "," urine turbid disease" onset,and "edema disease" accounted for the highest proportion.Traditional Chinese medicine syndrome type is mainly with spleen kidney qi deficiency syndrome,water dampness syndrome and blood stasis syndrome.3 The integral of TCM syndromes of the two groups after treatment were lower than before treatment,the difference was statistically significant(P<0.05);there was significant difference between the two groups(4 weeks,8 weeks)(P<0.05).The curative effect of TCM syndrome of the two groups was improved after treatment,and the difference was statistically significant(P<0.05).4 Two groups were compared in the 24-hour urine protein quantification,plasma total protein and plasma albumin.4.1 The 24-hour urine protein quantification of the two groups after treatment were lower than before treatment,and the difference was statistically significant at 4 weeks of the treatment group(P<0.05),and the difference was statistically significant at 8 weeks of the two groups(P<0.05);there was significant difference between the two groups(4 weeks,8 weeks)(P<0.05).4.2 The plasma total protein of the two groups after treatment were lower than before treatment,and the difference was statistically significant at 4 weeks of the treatment group(P<0.05),and the difference was statistically significant at 8 weeks of the two groups(P<0.05);there was significant difference between the two groups(8 weeks)(P<0.05).4.3 The plasma albumin of the two groups after treatment were lower than before treatment,and the difference was statistically significant(P<0.05);there was significant difference between the two groups(8 weeks)(P<0.05).5 The TC,TG,and LDL of the two groups after treatment were downward trend than before treatment,and the difference was statistically significant(P<0.05);but there was not significant difference between the two groups(P>0.05).6 The D-D dimer and fibrinogen of the two groups after treatment were lower than before treatment,and the difference was statistically significant(P<0.05);there was not significant difference between the two groups in D-D dimer(8 weeks)(P>0.05);but thedifference was statistically significant between the two groups in fibrinogen(P<0.05).7 After treatment,the two groups of patients were compared in platelet count,prothrombin time and activated partial thromboplastin time,and the difference was not statistically significant(P>0.05).Conclusions:1 It was found that the two groups of patients were mainly "edema disease" and "urine turbid disease ",and the TCM syndrome type was mainly spleen and kidney qi deficiency syndrome,water dampness syndrome and blood stasis syndrome.Xintong Changluo Traditional Chinese Medicine Decoction is superior to western medicine alone in the light of improving clinical symptoms of patients with idiopathic membranous nephropathy with hypercoagulability.2 Xintong Changluo Traditional Chinese Medicine Decoction can effectively reduce the24-hour urine protein quantification,fibrinogen,improve the total plasma protein and plasma albumin,and improve the lipid metabolism of patients.3 Xintong Changluo Traditional Chinese Medicine Decoction can improve the hypercoagulability of patients and prevent the occurrence of thromboembolism complications,which is beneficial to the treatment and prognosis of patients. |
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