Clinical Observation Of Modified Zengxiaojiandu Formula Combined With Glucocorticoid And Mycophenolate Mofetil In Treating Adult Primary Nephrotic Syndrome

Objective:In this study,we observed the effect of Modified Zengxiaojiandu Formula combined with glucocorticoid and mycophenolate mofetil on the clinical symptoms symptoms,signs and laboratory indicators of adult primary nephrotic syndrome patients,to evaluate its effectiveness and safety,and to explore its mechanism of action.It is expected to provide more better clinical treatment for primary nephrotic syndrome,and to provide a certain reference value for the combination of traditional Chinese and Western medicine treatment of chronic kidney diseases.Methods:1.Sources:From November 2018 to May 2020,62 adults with primary nephrotic syndrome were selected as observation cases.According to the random number table method,both treatment group and control group had 31 cases.2.Treatment:The control group was taken with conventional Western medicine standard treatment,including low-salt,low-fat,high-quality protein diet,symptomatic supportive treatments such as diuresis,anti-platelet aggregation,regulate fat,reducing albuminuria,glucocorticoid,mycophenolate mofetil,preventing osteoporosis,protecting the stomach,etc.On the basis of the control group,the treatment group was treated with Modified Zengxiaojiandu Formula for 12 weeks.The granules was one dose per day,150ml each time,warm-taken in the morning and evening after meals.After 24 weeks’treatment,the patients were followed up for2 months to observe whether there were any untoward effects.3.Indicators:After 24 weeks’treatment,we compared the changes of indicators in both groups of patients before and after treatment,including blood biochemistry(serum albumin,serum totalcholesterol,serumhigh-densitylipoprotein cholesterol,serum low-density lipoprotein cholesterol,serum creatinine,serum uric acid,blood urea nitrogen),24H urine protein quantification and TCM syndrome scores,and comprehensively evaluated the therapeutic effect of Modified Zengxiaojiandu Formula combined with glucocorticoid and mycophenolate mofetil on patients with adult primary nephrotic syndrome.At the same time,the safety indexes such as electrocardiography,blood routine,fecal routine,liver function,kidney function,electrolyte,coagulation function,blood pressure and blood glucose of the patients were observed.4.Data analysis:we used SPSS 22.0 statistical software for data processing and analysis.The experimental data were expressed as mean±standard deviation(?x±s).For measurement data,t-test was used for those conforming to normal distribution and homogeneous variance,and?~2test was used for counting data,while non-parametric test was used for those not conforming to normal distribution or heterogeneous variance.The test level wasα=0.05,and P<0.05 indicated statistically significant difference;otherwise,P>0.05 indicated no statistically significant difference.Results:1.There was statistically significant difference between the two groups(P<0.05).The total effective rate of the treatment group was 83.87%,and the control group was 61.29%,indicating that the efficacy of the treatment group was better than that of the control group.2.Comparison of indicators:Both groups were effective in increasing serum albumin,reducing total cholesterol,triglyceride,low density lipoprotein cholesterol,24h urinary protein and improving the degree of edema,with statistical significance(P<0.05).The efficacy of treatment group was better than that of control group.There was a significant difference in HDL-C in the treatment group before and after treatment(P<0.05),while there was no significant difference in HDL-C in the control group(P>0.05),and the efficacy of the treatment group was better than the control group.There were no significant differences in serum creatinine,urea nitrogen,serum uric acid and between the two groups before and after treatment(P>0.05).3.Comparison of TCM Symptom Scores and Syndrome Efficacy:Both groups had a significant difference in TCM symptom scores before and after treatment(P<0.05).The reduction of TCM symptom scores in the treatment group was better than that in the control group.The total effective rate of the control group was 70.97%,and the treatment group was 90.32%,the total curative effect of the treatment group was better than the control group.4.Evaluation of safety indicators:Before and after treatment,there were no abnormal changes in ECG,blood routine,fecal routine,liver function,renal function,electrolyte,coagulation function,blood pressure and blood glucose in the treatment group and the control group,and no adverse reactions occurred.Conclusion:Modified Zengxiaojiandu Formula combined with glucocorticoid and mycophenolate mofetil can significantly improve patients’edema symptoms,reduce proteinuria,increase serum albumin in patients with primary nephrotic syndrome,reduce total cholesterol,triglyceride,low density lipoprotein cholesterol,and increase high density lipoprotein cholesterol.The effect of Modified Zengxiaojiandu Formula has definite curative effect in clinical application,with no adverse reactions being found,and it is safe to put into use.It has clinical practical and popularization value.