Clinical Study On The Treatment Of Idiopathic Membranous Nephropathy By Tonifying Spleen And Kidney And Clearing Heat And Dampness

Objective: To observe the clinical efficacy and safety of the treatment of idiopathic membranous nephropathy by tonifying spleen and kidney and clearing heat and dampness,and to provide new ideas and methods for TCM syndrome differentiation and treatment of idiopathic membranous nephropathy.Methods: This topic research object from the September 2019-September 2020 in changchun university of Chinese medicine the first affiliated hospital of renal medicine inpatient and outpatient low-risk patients of idiopathic membranous nephropathy,and consistent with the inclusion criteria and exclusion criteria,all using the stochastic indicator method in 56 patients,randomly divided into two groups,28 cases in the control group,experimental group 28 cases.Patients in both groups were given low-salt,low-fat and high-quality protein diet and oral ACEI or ARB basic treatment.Patients in the control group were given basic treatment,and patients in the experimental group were given basic treatment,including traditional Chinese medicine decoction for invigorating the spleen and nourishing the kidney,clearing heat and dampness,for a course of 12 weeks.The changes of urinary microalbumin,24-hour urinary protein,serum albumin,serum total protein,serum anti-PLA2 R antibody and TCM syndrome scores in 2 groups before and after treatment were observed.Results:1.The total remission rate of the experimental group was 64.29%,and that of the control group was 41.67%,which was higher in the experimental group than in the control group(P <0.05).The efficacy of the two groups was statistically different.2.After treatment,TCM syndrome scores in both groups were lower than those before treatment,P < 0.05,showing a statistical difference.In addition,TCM syndrome scores in the test group were lower than those in the control group,P < 0.05,showing a statistical difference.Comparison of single integral of TCM syndrome between the two groups after treatment shows that the experimental group is significantly lower than the control group in terms of lumbago,edema,dry mouth,bitter mouth and yellow skin,P < 0.05,with statistical difference.3.After treatment,UMA,24-UTP and serum anti-PLA2 R antibody in 2 groups were decreased compared with before treatment(P < 0.05),and the experimental group was significantly lower than the control group(P < 0.05),with statistical difference.After treatment,ALB and TP in 2 groups were increased compared with before treatment,P < 0.05,with statistical difference,and the experimental group was significantly higher than the control group,P < 0.05,with statistical difference.4.There were no significant changes in blood routine,stool routine,renal function,ALT,AST,GGT,ECG and other safety indexes between the experimental group and the control group before and after treatment,P < 0.05,showing statistical differences.Conclusion:1.The treatment of idiopathic membranous nephropathy by invigorating spleen and invigorating kidney,clearing heat and removing dampness has a significant clinical effect,which can reduce the patients’ urinary protein,increase the levels of serum albumin and total protein,and reduce the concentration of anti-PLA2 R antibody.2.The method of invigorating the spleen and invigorating the kidney,clearing heat and reducing dampness can reduce the TCM syndrome scores of IMN patients,and significantly improve the clinical symptoms of patients,especially in the aspects of lumbago,edema,dry mouth,bitter mouth,and yellow skin for small immunization.3.The method of invigorating spleen and invigorating kidney,clearing heat and removing dampness in the treatment of IMN is safe and reliable,and no adverse reactions have been found,which is worthy of popularization and application.