| BackgroundIgA nephropathy(IgAN)is the most common primary glomerular disease in the world,which can occur at any age,but most of them are young and middle-aged.The clinical manifestations of IgAN are varied,mainly hematuria and albuminuria,and may be accompanied by varying degrees of hypertension and impaired kidney function.30 to 40%of patients develop End stage renal disease(ESRD)20 to 30 years after diagnosis of IgAN.It imposes a serious economic burden on individuals and society.According to the guidelines of the Organization for Improving the Prognosis of Kidney Diseases Worldwide(KDIGO),the current treatment of IgAN mainly involves the use of RAS blockers to reduce urinary protein,control blood pressure,and protect renal function.However,the use of glucocorticoids is controversial and not recommended,and hormones and immunosuppressants often cause adverse reactions to varying degrees,so the clinical application is very limited.TCM treatment of IgAN can reduce hematuria and albuminuria in patients,protect renal function,and reduce the side effects of hormone or immunosuppressive therapy,and its clinical advantages are increasingly prominent.The syndrome of Qi and Yin deficiency is often witnessed by IgAN.Professor Zhao Wenjing inherited the academic thought of "Eight methods of tonifying kidney" by Professor Zhang Binghou,a famous Chinese doctor.According to the characteristics of Qi and Yin deficiency combined with blood heat in IgAN,based on the ground turtle Soup,he formulated the formula of invigorating qi and nourishing kidney and cooling blood.ObjectiveThe purpose of this study was to investigate the efficacy and safety of supplementing Qi and kidney and cooling blood prescription in the treatment of IgAN with deficiency of Qi and Yin.MethodsA prospective randomized control method was used to collect 60 IgAN patients diagnosed by renal biopsy in the nephrology Department of Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University,and they were randomly divided into treatment group and control group.Both groups were given basic treatment;the treatment group was given Yiqi Zishen Liangxue prescription,and the control group was given Shenyan Confuxing tablet.After 6 months of treatment,efficacy indexes(24h urinary protein quantitation,urinary red blood cell count,serum creatinine,urea nitrogen,estimated glomerular filtration rate,blood albumin,TCM syndrome score)and safety indexes(alanine aminotransferase,glutamic oxalacetic aminotransferase,hemoglobin,white blood cells,platelets,serum potassium)were measured once before treatment and once at 1 month,2 month,April and 6 month after treatment.SPSS 23.0 software was used to analyze the data,and the clinical effect of Yiqi Zishen Liangxue prescription on IgAN was discussed.ResultsIn this study,one control patient dropped out due to lost follow-up during treatment,and 59 patients finally completed treatment.There was no statistical difference in baseline data between the two groups(P>0.05),which was comparable.The total effective rate of treatment group and control group was 93.33%vs 79.31%(P<0.05).The treatment group was better than the control group in improving urine red blood cell count and 24-hour urinary protein quantitation(P<0.05).The baseline median albuminuria of the treatment group and the control group were 1.46g/24h and 1.28g/24h,respectively.The median albuminuria at 6 months after treatment was 0.63g/24h and 1.01g/24h,respectively.The median urine red blood cell count at baseline was 33.03/HP and 27.64/HP,respectively.The median urine red blood cell count at 6 months after treatment was 12.57g/HP and 22.56/HP,respectively.In terms of improving renal function(SCr,BUN,eGFR),blood SCr and BUN decreased and eGFR increased after treatment in both groups,the difference was statistically significant(P<0.05),but there was no statistically significant difference between groups(P>0.05).In terms of the total score of TCM syndromes,the score of TCM syndromes after treatment was significantly lower than that before treatment,and the difference was statistically significant(P<0.01),the treatment group was better than the control group,and the total score of TCM syndrome in the treatment group was lower than that in the control group at 4 and 6 months after treatment,and the difference was statistically significant at 4 months(P<0.05),the difference was statistically significant in the 6th month(P<0.01).Conclusion1.Supplementing qi and invigorating kidney and cooling blood can reduce the 24hUTP and hematuria levels of IgAN patients,and the clinical efficacy is obviously better than that of the control group.2.Supplementing Qi and nourishing kidney and cooling blood can reduce SCr and BUN to a certain extent,improve eGFR,thereby protecting kidney function and delaying disease progression.3.Yiqi Zishen Liangxue prescription can significantly improve the symptoms of shortness of breath,spontaneous sweating,night sweating,waist and knee tenderness,hands and feet heart heat and other symptoms of IgAN patients,and improve the quality of life of patients.4.Yiqi Zishen Liangxue prescription has good safety in the treatment of IgAN,and no obvious adverse reactions have been observed. |
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