Observation On The Effect Of Traditional Chinese Medicine "preventive Treatment" Combined With Chronic Disease Management On Delaying The Progression Of Low- To Medium-risk Membranous Nephropath

Objective: To evaluate the clinical efficacy of traditional Chinese medicine(TCM)"preventive treatment for disease" combined with chronic disease management model in patients with low and medium risk membranous nephropathy,and to explore the advantages and characteristics of TCM "preventive treatment for disease" combined with chronic disease management model in delaying the progression of membranous nephropathy and improving the quality of life of patients,so as to provide a new plan for clinical diagnosis and treatment.Materials and methods:Patients with low and medium risk membranous nephropathy who met the diagnostic criteria of traditional Chinese and western medicine in the Department of Nephrology,Affiliated Hospital of Liaoning University of Chinese Medicine from September 2021 to June 2022 were collected.According to the inclusion and exclusion criteria,80 patients were selected and randomly divided into experimental group and control group,with 40 cases in each group.During the observation,2 cases dropped out of the experimental group and 2 cases dropped out of the control group.Finally,there were 38 cases in the experimental group and 38 cases in the control group,and the total data was 76 cases.The control group was treated with oral TCM syndrome differentiation decoction and western medicine for membranous nephropathy.On the basis of the treatment of the control group,the experimental group was added with the traditional Chinese medicine "preventive treatment for disease" combined with chronic disease management model.All patients were treated for 6 months.The total TCM syndrome score,24-hour urinary protein quantitative(UTP),serum albumin(ALB),serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(e GFR),triglyceride(TG),cholesterol(CHO),quality of life quantitative score(SF-36)and safety indicators were compared between the two groups before and after treatment The changes.Results:1 Clinical efficacy: The total effective rate of the experimental group was 63.2%,which was better than 55.3% of the control group,but there was no statistically significant difference(P>0.05).2 The total TCM syndrome score: After treatment and management,the total TCM syndrome score of the two groups was significantly reduced(P<0.01),and the experimental group was better than the control group(P<0.05).3 24 hours urinary protein and serum albumin: After treatment and management,UTP decreased(P<0.05),ALB increased significantly(P<0.01)in the experimental group,and there was no significant change in the control group(P>0.05),and the experimental group was better than the control group(P<0.05).4 Renal function: After treatment and management,Scr,BUN and e GFR in the experimental group remained stable(P>0.05).Scr increased and e GFR decreased significantly(P<0.01),BUN had no significant change(P>0.05)in the control group.Scr and e GFR in the experimental group were better than those in the control group(P<0.05).There was no significant difference in BUN(P>0.05).5 Blood lipid: After treatment and management,TG and CHO decreased significantly(P<0.05,P<0.01)in the experimental group,but there was no significant change in the control group(P>0.05),and the experimental group was better than the control group(P<0.05).6 Scores of quality of life: After treatment and management,the total score of quality of life,life function score,body pain score,energy score and mental health score of the experimental group were significantly increased(P<0.01),and the physical function score,general health score,social function score and emotional function score were significantly increased(P<0.05).There was no significant change in the total score and each dimension score of quality of life in the control group(P>0.05).The total score and each dimension score of quality of life in the experimental group were better than those in the control group(P<0.05).7 Safety indicators: There were no obvious adverse reactions and adverse events in the two groups during the treatment and management,and the safety indicators were still in the normal range.Conclusion:1 TCM "preventive treatment for disease" combined with chronic disease management can effectively reduce the total TCM syndrome score of MN patients with low and medium risk,and has advantages in improving TCM syndrome symptoms.2 TCM "preventive treatment" combined with chronic disease management can help to improve UTP and ALB levels in MN patients with low and medium risk,slow down protein loss,and protect renal function.Maintain the stability of Scr,BUN and e GFR,delay the progression of renal function;Reduce TG and CHO to prevent cardiovascular and cerebrovascular complications.3 TCM "prevention of disease" combined with chronic disease management can help improve UTP and ALB levels,slow down protein loss and protect renal function in low-middle-risk MN patients;Maintain the stability of Scr,BUN and e GFR,and delay the progression of renal function;Reduce TG and CHO and prevent cardiovascular and cerebrovascular complications.4 TCM "preventive treatment" combined with chronic disease management is safe in the process of clinical treatment and management,which is worthy of further detailed research and clinical application.