| ObjectiveTo analyze the clinical efficacy of ephedra decoction in patients with membranous nephropathy and to explore the clinical significance of urine podocyte particulate level in long-term follow-up.MethodsThis study is a single-center,observational study with clinical data of patients with idiopathic membranous nephropathy treated in the nephrology clinic of Liu Baoli of Beijing Hospital of Traditional Chinese Medicine from 2022 to 2023 and morning urine samples of some patients from 2022 to 2023 for analysis.Eligible patients with idiopathic membranous nephropathy were screened according to inclusion and exclusion criteria,and all patients received a perihedra decoction as the main formula.Clinical data from the initial visits of patients with collected clinical data will be used as baseline data,and clinical data collected until the end of collection will be used as outcome data.Clinical data from the morning urine specimen in patients studying urinary podocyte particulate level were started as baseline data,and clinical data from the time of the last morning urine specimen were analyzed as outcome data.With serum albumin,24 hours urinary protein quantification as the main efficacy index,with liver and kidney function laboratory data as a safety index,according to the patient after treatment serum albumin,24 hours of urinary protein,clinical symptoms to determine the outcome of the patients,the outcome as complete remission,partial relief and not remission,to explore the treatment of idiopathic membranous nephropathy.In addition,its clinical significance in patients with idiopathic membranous nephropathy was explored by comparing the changes in the two morning urine periods and the association with clinically relevant indicators.ResultsA total of 80 patients with idiopathic membranous nephropathy were included in this clinical study,and all of them were regularly followed up at Director Liu Baoli Clinic of Beijing Hospital of Traditional Chinese Medicine.Among them,49 patients were male and 31 were female,with an average age of 51(40.25,59.75)years old,including 56 patients with nephrotic syndrome,accounting for 70%.After analyzing the data,it was found that the effective rate of treating idiopathic membranous nephropathy was 76.25%.The changes in the clinical indicators were as follows:24-hour urinary protein decreased to 1.53(0.49,5.39)g/24h,serum albumin to 39.65(34.55,42.70)g/L,triglycerides to 1.78(1.27,2.49)mmol/L,and total cholesterol to 3.23(2.83,4.92)mmol/L,all statistically significant(p<0.05).Whether the patient initially had nephrotic syndrome is somewhat correlated with the baseline albumin level,the 24-hour urinary protein quantification level,and the remission time(p<0.05).In terms of renal function,serum creatinine levels decreased significantly after treatment(p<0.05),and the estimated glomerular filtration rate increased significantly(p<0.05).In terms of liver function,the levels of alanine aminotransferase and aspartate aminotransferase did not change significantly before and after treatment(p<0.05).A total of 25 patients collected morning urine specimens for comparative analysis,Of these,12 were male patients,Of the 13 female patients,Age,21-67 years,Mean age of 49(39,57.5),years old,The ratio of urinary podocyte particles to urine creatinine was 73080±69102,The ratio of urinary podocyte microparticles to urine creatinine was 50952±45354,The mean duration of treatment was 35(13.5,47),Months,No significant changes in urinary podocyte particulate level before and after medication(p<0.05),A statistically significant association with the medication course(p<0.05).ConclusionEphedra decoction is effective in the treatment of membranous nephropathy,and the urine podocyte microparticle level has preliminary exploration significance in the evaluation of patients’ conditions. |
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