Effects Of Modified Huangqi Chifeng Decoction On Proteinuria And Urinary TGF-?1 And MCP-1 In Patients With IgA Nephropathy

OBJECTIVE:To investigate the clinical effects of modified Huangqi Chifeng Decotion(MHCD)on proteinuria,urinary transforming growth factor betal(TGF-?1)and MCP-1(monocyte chemotactic protein 1(MCP-1)in the urine of patients with IgA nephropathy(IgAN),which is caused by qi deficiency and blood stasis combined with the syndrome of wind pathogenic heat.METHODS:According to the inclusion criteria,60 eligible IgA nephropathy patients with Qi deficiency and blood stasis combined with wind pathogenic heat toxic type(CKD1-2 stage)were randomly divided into 30 cases in control group who received telmisartan on the basis of conventional treatment and 30 cases in experimental group who were treated with Jiawei Huangqi Chifeng Granules.The treatment period for both groups was 24 weeks.The 24-hour urinary protein level,urinary TGF-?1 and MCP-1 were measured at week 0,12 and 24 respectively.The TCM symptom score,blood routine,serum creatinine,urea nitrogen,uric acid,albumin and triglyceride were recorded at week 0 and 24.Liver function,blood routine examination and the incidence of adverse reactions were measured before and after treatment.RESULTS:?Compared with before treatment,the amount of urine protein at 24 h after 12 and 24 weeks of treatment in experimental group and control was significantly decreased(P<0.01,P<0.05);.However,the 24-hour urinary protein level in 12 and 24 week test groups was significantly lower than that in control group(P<0.05,P<0.01).?Comparison of TGF-?1 and MCP-1 levels between the two groups:Compared with before treatment,TGF-?1 and MCP-1 levels in the experimental group were decreased,the difference was statistically significant(P<0.01,P<0.05),and better than that in the control group(P<0.05).?Comparison of TCM symptom scores:Compared with before treatment,the TCM symptom scores of both experimental group and control group decreased after 24 weeks of treatment(P<0.01),and the experimental group was better than the control group(P<0.05).?Comparison of the efficacy of TCM syndromes:the total effective rate of the experimental group was 88%,while that of the control group was 48.14%,and the difference between the two groups was statistically significant(P<0.05).?Safety analysis:There were no significant changes in blood routine,liver and kidney function before and after treatment in the two groups(P>0.05).CONCLUSION:Modified Huangqi Chifeng Granules can improve TCM symptoms in patients with IgA nephropathy,reduce the 24-hour urinary protein level,stabilize renal function,and may reduce the inflammatory response of IgA nephropathy,Reduce the pathological injury of kidney and delay the progression of renal fibrosis by reducing the levels of urinary TGF-?1 and MCP-1.There was no obvious adverse reaction,and the clinical medication was safe.