Clinical Observation of Modified Zhenwu Decoction and Shenzhuo Decoction on Idiopathic Membranous Nephropathy with Acute Kidney Injury
Objective:To evaluate the clinical efficacy and mechanism of Modified Zhenwu Decoction and Shen-zhuo Decoction in the treatment of idiopathic membranous nephropathy(IMN)with acute kidney injury(AKI).Methods:A total of 106 patients were randomly divided into control group and observation group,with 53 cases in each group.The control group received comprehensive treatment,while the observation group received oral ad-ministration of Modified Zhenwu Decoction and Shenzhuo Decoction on the basis of the control group,taking one dose per day for four consecutive weeks.Scr,BUN,Ccr,24 h-UTP,ALB,TAG,TC,Hcy,NAG,β2-MG,Kim-1 and anti PLA2R antibody titer levels were compared before and after treatment;CD4+,CD8+and CD4+/CD8+,TNF-α,IL-1β,IL-17,IL-35 were measured;spleen and kidney yang deficiency syndrome scores were performed;the overall response rate of the disease after treatment was compared.Results:There were no significant differenc-es in these indicators before treatment(all P＞0.05).After treatment,24 h-UTP,Scr,BUN,TAG,TC,Hcy,NAG,β2-MG,Kim-1 and anti anti PLA2R antibody levels decreased in both groups(P＜0.05),and Ccr and ALB levels increased in both groups(P＜0.05),and they were significantly better in the observation group(P＜0.05).After treatment,the main symptom score and total score of spleen-kidney yang deficiency syndrome in the two groups decreased(P＜0.05),and the observation group was lower than the control group(P＜0.05).After treatment,IL-35,CD4+and CD4+/CD8+in the observation group were higher than those in the control group(all P＜0.05),and TNF-α,IL-1β,IL-17 and CD8+levels were lower than those in the control group(all P＜0.05).The total effec-tive rate in the observation group was 92.45％,which was significantly higher than 75.47％in the control group(P＜0.05).Conclusion:Modified Zhenwu Decoction and Shenzhuo Decoction in the treatment of IMN with AKI can regulate immune inflammatory factors,inhibit anti PLA2R antibody,reduce renal injury and proteinuria,pro-tect renal function,and improve clinical symptoms.
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