| Purpose: Observe the clinical effect of Buyi Tongluo Recipe in the treatment of patients with idiopathic membranous nephropathy of spleen and kidney Yang deficiency and wet stasis type,and analyze the effect of this prescription on M-type antiphospholipid A2 receptor antibody.Material and method: Select patients who were hospitalized in the Department of Nephrology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2017 to December 2019,and were diagnosed as adult patients with Idiopathic Membranous Nephropathy by renal biopsy stage I-II and the syndrome is spleen and kidney Yang deficiency and wet stasis Using a retrospective analysis method,based on the established inclusion and exclusion criteria,a total of 60 patients met the requirements,including 30 patients in the Western medicine group and 30 patients in the Chinese and Western medicine group.Patients in the Western medicine group were treated with hormones plus cyclophosphamide.Patients in the Chinese and Western medicine group were treated with Buyi Tongluo Formula combined with hormones plus cyclophosphamide for 6 months.Observe the changes of urine protein quantitation,plasma albumin,plasma fibrinogen,serum cholesterol,TCM symptom score,etc.at 24 h before and after treatment in the two groups of patients,and compare the differences in efficacy between the two groups.Observe the changes of M-type antiphospholipid A2 receptor antibody before and after treatment in two groups of patients and the remission rate of antibody-positive patients.Results:1 Comparison of TCM syndrome scores before and after treatment in the two groups of patientsThere was no statistically significant difference in TCM symptom scores between the two groups of patients before treatment.After group treatment,the TCM symptom scores of both groups decreased.The degree of symptom scores of the Chinese and Western medicine groups decreased more significantly.(P <0.05).2 Comparison of laboratory indicators before and after treatment in two groups of patientsThere was no statistically significant difference in laboratory indicators between the two groups of patients before treatment.After group treatment,the laboratory indicators of both groups were improved.The improvement of the patients in the Chinese and western medicine group was more significant.(P <0.05).3 Comparison of treatment effectiveness between two groups of patientsComparison of disease efficacy: Compared with before treatment,the laboratory indicators of both groups of patients have improved.The effective rate of the western medicine group is 73.33%,and the effective rate of the western medicine group is 86.67%.Comparing the efficacy of TCM symptoms: Compared with before treatment,the symptoms and signs of both groups were improved.The effective rate of the western medicine group was 70%,and the effective rate of the traditional Chinese medicine group was90%.4 M-type antiphospholipase A2 receptor antibody response to treatment4.1 The positive rate of M-type antiphospholipase A2 receptor antibody before treatment,the decline rate after treatment,and the negative rate in both groups of patientsThe positive rates of M-type antiphospholipase A2 receptor antibodies in the western medicine group and the western medicine group before treatment were 66.67% and 70%,respectively.After 6 months of continuous treatment,the negative rates of the western medicine group and the western medicine group were 10% and 28.58,respectively.The decline rates of the western medicine group and the western medicine group were 50% and52.38%,respectively.4.2 M-type antiphospholipase A2 receptor antibody-positive patientsAfter treatment,M-type antiphospholipase A2 receptor antibody-positive patients had a complete response rate of 19.51%,a partial response rate of 39.02%,and a total response rate of 58.53%.Conclusion:1.Tonifying Tongluo Formula can improve the symptoms and signs of patients with idiopathic membranous nephropathy of spleen and kidney Yang deficiency and wet stasis tovarying degrees2.Tonifying Tongluo Formula can effectively reduce the 24-hour urine protein quantity,effectively increase the plasma albumin level,and effectively improve the plasma fibrinogen and serum cholesterol;3.The most clinically specific antibody for idiopathic membranous nephropathy is the M-type antiphospholipid A2 receptor antibody.The antibody titer level gradually decreases or turns negative with treatment,and is closely related to the disease remission.It is of great significance to the patient's clinical diagnosis,monitoring the condition and speculating the prognosis. |
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