Lv Wei, Wang Mei-Rong, Zhang Cheng-Zhen, Sun Xue-Xu, Yan Zhen-Zhen, Hu Xiao-Min, Wang Tao-Tao
Department of Nephology, China People's Liberation Army 32298, Weifang 261000, Shandong Province, China.
Department of Pharmacy, China People's Liberation Army 32298, Weifang 261000, Shandong Province, China.
World J Clin Cases. 2021 Dec 6;9(34):10464-10471. doi: 10.12998/wjcc.v9.i34.10464.
Idiopathic membranous nephropathy (IMN) has a high incidence in the middle-aged and elderly population, and poses a great threat to the physical and mental health and quality of life of patients. Nephritis Rehabilitation Tablets have many potential effects, such as clearing residual toxins, tumefying the kidney and spleen, replenishing qi, and nourishing yin, and have played an important role in the treatment of a variety of kidney diseases.
To investigate the efficacy and safety of Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN.
Eighty-four patients with IMN recruited from January 2017 to September 2020 were randomly divided into a study group ( = 42) and a control group ( = 42). On the basis of routine symptomatic treatment, both groups were treated with tacrolimus, and the study group was additionally treated with Nephritis Rehabilitation Tablets. Both groups were treated for 12 wk. The therapeutic effect, the levels of renal function indexes [serum creatinine (Scr), serum albumin, and 24-h urinary protein], urinary immunoglobulin (IgG4), membrane attack complex (C5b-9), and the incidence of adverse reactions were measured before and after 12 wk of treatment.
The total effective rate in the study group was significantly higher than that of the control group. Before treatment, there was no significant difference in Scr, serum albumin, or 24 h urinary protein between the two groups. After 12 wk of treatment, the levels of Scr and 24-h urinary protein in both groups were significantly lower and serum albumin was significantly higher than those before treatment ( < 0.05), and the levels of Scr and 24-h urinary protein were significantly lower ( = 0.003 and 0.000, respectively), and the level of serum albumin was significantly higher ( = 0.00) in the study group than in the control group. Before treatment, there was no significant difference in urinary IgG4 and C5b-9 levels between the study group and the control group ( = 0.336 and 0.438, respectively). After 12 wk of treatment, the levels of urinary IgG4 and C5b-9 in the two groups were lower than those before treatment, and the levels of urinary IgG4 and C5b-9 in the study group were significantly lower than those in the control group ( = 0.000). There was no significant difference in the incidence of adverse reactions between the two groups ( = 0.710).
Based on routine intervention, Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN can effectively improve the renal function of patients and downregulate the expression of urinary IgG4 and C5b-9. In addition, they can improve the overall therapeutic effect while not increasing the risk of adverse reactions.
特发性膜性肾病（IMN）在中老年人群中发病率较高，对患者身心健康及生活质量构成极大威胁。肾炎康复片具有诸多潜在作用，如清除残余毒素、健脾益肾、补气养阴等，在多种肾脏疾病治疗中发挥了重要作用。
探讨肾炎康复片联合他克莫司治疗IMN的疗效及安全性。
选取2017年1月至2020年9月收治的84例IMN患者，随机分为研究组（n = 42）和对照组（n = 42）。两组均在常规对症治疗基础上给予他克莫司治疗，研究组加用肾炎康复片。两组均治疗12周。分别于治疗12周前后测定治疗效果、肾功能指标[血清肌酐（Scr）、血清白蛋白、24小时尿蛋白]水平、尿免疫球蛋白（IgG4）、膜攻击复合物（C5b - 9）水平及不良反应发生率。
研究组总有效率显著高于对照组。治疗前，两组Scr、血清白蛋白及24小时尿蛋白水平比较，差异无统计学意义。治疗12周后，两组Scr及24小时尿蛋白水平均显著低于治疗前，血清白蛋白水平显著高于治疗前（P < 0.05），且研究组Scr及24小时尿蛋白水平显著低于对照组（分别为P = 0.003和0.000），血清白蛋白水平显著高于对照组（P = 0.00）。治疗前，研究组与对照组尿IgG4及C5b - 9水平比较，差异无统计学意义（分别为P = 0.336和0.438）。治疗12周后，两组尿IgG4及C5b - 9水平均低于治疗前，且研究组尿IgG4及C5b - 9水平显著低于对照组（P = 0.000）。两组不良反应发生率比较，差异无统计学意义（P = 0.710）。
在常规干预基础上，肾炎康复片联合他克莫司治疗IMN可有效改善患者肾功能，下调尿IgG4及C5b - 9表达，提高总体治疗效果，且不增加不良反应发生风险。
