Study On The Intervention Based On The Adjustable Physique Theory Of TCM Use Yiyuan Jianzhong Decoction On The Period Of Qi-Deficiency And In Remission Of Idiopathic Membranous Nephropathy

ObjectiveBased on the theory of adjustable physique in traditional Chinese medicine,this study used Yiyuan Jianzhong Decoction to treat patients with Idiopathic membranous nephropathy(IMN)due to deficiency of Qi during the remission period.We observed the physical changes and recurrence of IMN within 9 months after treatment,and observed the relationship between changes in relevant indicators such as Anti-phospholipase A2 receptor antibodies,24-Hour urine protein quantification,Serum albumin,and the recurrence of IMN during the remission period,providing reference for the TCM constitution differentiation and treatment of IMN.MethodsSeventy patients with IMN remission period and TCM physique type of Qi-deficiency were randomized and divided into test group and control group,with 35 patients in each group.According to the exclusion criteria,34 cases were actually included in the experimental group and 33 cases were actually included in the control group.The control group was treated with conventional western medicine in the IMN remission period,and the test group was treated with Yiyuan Jianzhong Decoction on the basis of the control group.After the completion of intervention,t-he recurrence of IMN in the two groups will be observed and compared within 9 months.And observe and compare the two groups before treatment,at the end of the 12 weeks of treatment,3 months after the end of treatment,and 9 months after the end of treatment,With the changes of Pinghe physique transformation score,Qi-deficiency physique transformation score,the 24-Hour Urine protein(24h Upro),the Anti-phospholipase A2 receptor antibody(Anti-PLA2RAb),Serum albumin(ALB),Serum uric acid(UA),Serum creatinine(Scr),Total cholesterol(TC),Triglyceride(TG),An-d its relationship with the recurrence rate of IMN in remission,Data processing and analysis were performed using SPSS23.0 statistical software.Results1.Before treatment,there was no significant difference between the test gr-oup a nd the control group in terms of general data,curative effect observation index,TCM physique transformation score(Pinghe physique transforma-tion score,Qi-deficiency physique transformation score)and safety index(P>0.05),which was comparable.2.In the control group of 33 cases,The 24 h Upro,Anti-PLA2 RAb and Scr decreased after 12 weeks of treatment(P<0.05),24 h Upro and Anti-PLA2 RAb increased in the 3 months and 9 months after the end of treatment;ALB did not improve significantly after treatment;UA and TG decreased compared with those before treatment(P<0.01),and TC decreased compared with those before treatment(P<0.05);The Pinghe physique transformation score increased compared to the previous period(P<0.05),while the Qi-deficiency physique transformation score decreased compared to the previous period(P<0.05).3.24 hours Upro and Anti-PLA2 RAb in 34 patients in the test group decreased after treatment,including 12 weeks of treatment,3 months after the end of intervention treatmentt(P<0.01)and 9 months after the end of intervention treatment(P<0.05);Scr,TG,TC and UA decreased compared with those before treatment,Scr(P<0.05),TG,UA and TC(P<0.01);ALB and the Pinghe physique transformation score increased compared to the previous period(P<0.01),while the Qi-deficiency physique transformation score decreased compared to the previous period(P<0.01).4.Compared with the two groups,the improvement of 24 h Upro,Anti-PLA2 RAb,ALB,TC,TG,the Pinghe physique transformation score and the Qi-deficiency physique transformation score in the test group was better than that in the control group(P<0.05),At the same time,it was found that there was no significant difference in the improvement of Scr and UA between the two groups(P>0.05).5.In terms of clinical comprehensive effect after treatment,the recurrence rate of the test group was 11.76%,and that of the control group was 33.33%.The recurrence rate of the control group was higher than that of the test group(P<0.05);The conversion rate of the test group was 44.12%,and that of the control group was 18.18%.The conversion rate of the test group was higher than that of the control group(P<0.05).6.There was a positive correlation between 24 h Upro and Anti PLA2 RAB,while the correlation analysis of 24 h Upro,Anti-PLA2 RAb and Scr,TG,TC and Qi-deficiency physique transformation score showed a positive correlation,and negatively correlated with ALB,Pinghe physique transformation score(P<0.05).Neither of them was significantly correlated with UA in serum(P>0.05).Conclusions1.Yiyuan Jianzhong Decoction combined with conventional western medicine treatment to improve the Pinghe physique transformation score,make the IMN patients with Qi-deficiency tend to be calm,effectively reducing the recurrence rate of IMN patients within9 months,which is superior to western medicine treatment alone.2.Yiyuan Jianzhong Decoction combined with conventional western medicine can effectively reduce 24 h Upro,Anti-PLA2 RAb,Scr,TG and TC,and improve ALB level.The overall effect is better than that of western medicine alone.3.According to the analysis of correlation results,it is speculated that the higher of24 h Upro,Anti-PLA2 RAb,Scr,TG,TC and the Qi-deficiency physique transformation,the greater the recurrence probability;The higher the ALB and the Pinghe physique transformation score,the lower the recurrence probability;It is also speculated that there is no significant correlation between recurrence of IMN and UA.4.During the experiment of this subject,the patient safety evaluation indexes were normal,and there were no related side effects during the course of treatment,which could be further promoted in clinical use.