The First Hospital of China Medical University, 155 Nanjing Street, Heping District, Shenyang, 110002, China.
Int Urol Nephrol. 2024 Feb;56(2):699-706. doi: 10.1007/s11255-023-03682-2. Epub 2023 Jul 22.
Idiopathic membranous nephropathy (IMN) is the most frequent global cause of nephrotic syndrome in non-diabetic people. In clinical practice, An effective and mild treatment for IMN patients with subnephrotic proteinuria has been adopted. Colquhounia root tablet (CRT) is a traditional Chinese medicine that is widely used in China to treat glomerulopathies. In this study, the effectiveness and safety of CRT in the treatment of IMN with subnephrotic proteinuria have been determined by reviewing the clinical records of 44 patients with IMN.
Retrospective analysis of IMN patients with subnephrotic proteinuria treated with CRT in combination with ACEI/ARB or ACEI/ARB alone. The remission rate (complete or partial remission) was the main outcome observed, and proteinuria, estimated glomerular filtration rate (eGFR), serum albumin levels, and adverse effects were the secondary outcomes.
This clinical trial included 44 patients, and the overall remission rates at months 6, 9, and 12 after treatment were 68.2% versus 27.3% (p = 0.016), 72.7% versus 36.4% (p = 0.015), and 77.3% versus 36.4% (p = 0.006) in the treatment and control groups, respectively. The application of CRT treatment was an independent predictor of proteinuria remission (p = 0.024). In addition, in patients who were positive for phospholipase A2 receptor (PLA2R) antibodies, the overall remission rate was higher in the treatment group than in the control group after 9 months of treatment (75% versus 23.08%, p = 0.017).
This retrospective study illustrates that, based on supportive therapy, CRT could be effective in the treatment of IMN with subnephrotic proteinuria with a good safety profile at the same time.
特发性膜性肾病（IMN）是全球非糖尿病患者肾病综合征最常见的病因。在临床实践中，对于伴有亚肾病蛋白尿的 IMN 患者，已经采用了一种有效且温和的治疗方法。苦参片（CRT）是一种中药，在中国广泛用于治疗肾小球疾病。在这项研究中，通过回顾 44 例 IMN 患者的临床记录，确定 CRT 治疗伴有亚肾病蛋白尿的 IMN 的有效性和安全性。
对伴有亚肾病蛋白尿的 IMN 患者进行 CRT 联合 ACEI/ARB 或 ACEI/ARB 单药治疗的回顾性分析。主要观察终点为缓解率（完全或部分缓解），次要观察终点为蛋白尿、估算肾小球滤过率（eGFR）、血清白蛋白水平和不良反应。
本临床试验共纳入 44 例患者，治疗后 6、9、12 个月的总体缓解率分别为 68.2%与 27.3%（p=0.016）、72.7%与 36.4%（p=0.015）和 77.3%与 36.4%（p=0.006），治疗组明显优于对照组。CRT 治疗的应用是蛋白尿缓解的独立预测因素（p=0.024）。此外，在磷脂酶 A2 受体（PLA2R）抗体阳性的患者中，治疗组 9 个月后的总体缓解率高于对照组（75%与 23.08%，p=0.017）。
本回顾性研究表明，在支持治疗的基础上，CRT 可能对伴有亚肾病蛋白尿的 IMN 有效，同时具有良好的安全性。
