| Purpose:（1）To retrospectively analyze the efficacy and adverse reactions of Tripterygium hypoglaucum（Levl.）Hutch in the treatment of membranous nephropathy.（2）To compare the curative effect of Tripterygium hypoglaucum（Levl.）Hutch with ACEI/ARB agents in the treatment of patients with membranous nephropathMethods:（1）Research subjects: Retrospectively collected patients diagnosed with membranous nephropathy（MN）by renal pathology or serum PLA2 R antibody detection in the First Hospital of Jilin University from January 2019 to December 2021,and treated with Chinese patent medicines with Tripterygium hypoglaucum（Levl.）Hutch as the main formula ingredient（including Kunxian Capsule and Huobahuagen Tablets）at least 3 months.The enrolled patients all had complete clinical follow-up data.And patients who were treated with ACEI/ARB agents after diagnosis of MN during the same period were selected as controls.（2）Grouping: Patients were divided into single drug group（treatment only with Tripterygium hypoglaucum（Levl.）Hutch）,combination group（Tripterygium hypoglaucum（Levl.）Hutch combined with glucocorticoids and/or immunosuppressants）and observed group（treatment with ACEI/ARB agents）according to their medication status;The single drug group was divided into previous untreatment group and retreatment group according to whether the patients used glucocorticoid and immunosuppressive therapy before treatment or not;Divided into low-level group（<4g）,intermediate-level group（4-8g）and high-level group（>8g）according to 24-hour urine protein quantification of patients.（3）Recorded data: The results of 24-hour urine protein,serum creatinine,e GFR,serum albumin,aspartate aminotransferase,alanine aminotransferase,blood lipids,blood routine and etc.were collected during the follow-up period in our hospital and record adverse reactions.（4）Data analysis: Compare the changes of clinical indicators before and after treatment in the single-drug group or combination group and evaluate the curative effect;Compare the changes of24-hour urine protein,serum creatinine,e GFR,serum albumin before and after treatment between the previous untreatment group and the retreatment group,or the single-drug group and observed group.Results:（1）After 3 or 6 months of treatment in the single drug group,the 24-hour urine protein level was significantly decreased（P < 0.01）,whereas there was no difference in serum creatinine,e GFR and albumin levels before and after treatment（P > 0.05）.（2）There was no significant difference in curative effect between the previous untreatment group and the retreatment group after 3 months of treatment（P>0.05）,and the 24-hour urine protein in the previous untreatment group decreased significantly（P<0.05）.（3）Compared with ACEI/ARB agents,Tripterygium hypoglaucum（Levl.）Hutch could more significantly decreased proteinuria in patients with MN（P < 0.05）.（4）Patients treatment with Tripterygium hypoglaucum（Levl.）Hutch have fewer and milder adverse reactions.Conclusions:（1）Tripterygium hypoglaucum（Levl.）Hutch treatment can reduce urinary protein and stabilize renal function in patients with MN.It has no obvious effect on the elevation of serum albumin,and the adverse reactions are few and mild.（2）Compared with ACEI/ARB,Tripterygium hypoglaucum（Levl.）Hutch can more significantly reduce urinary protein in patients with MN,and increase rate of remission. |
