加味健肾方联合他克莫司治疗特发性膜性肾病的临床疗效及对肾功能、抗PLA2R抗体水平的影响OA

Objective To investigate the clinical efficacy of Jiawei Jianshen decoction combined with ta-crolimus in the treatment of idiopathic membranous nephropathy(IMN)and its effect on renal function and anti-phospholipase A2 receptor(PLA2R)antibody level.Methods A total of 106 patients with IMN admitted to Beijing Changping District Hospital of Traditional Chinese Medicine from January 2022 to December 2024 were selected as the research objects,and they were divided into control group and observation group by ran-dom number table method,with 53 cases in each group.The control group was treated with tacrolimus in addi-tion to basic treatment,and the observation group was treated with Jiawei Jianshen decoction on the basis of the control group.After 3 months of treatment,the curative effect was evaluated.The curative effect of west-ern medicine was evaluated according to clinical symptoms,signs,24 h urinary protein quantification(24 hUP)and serum albumin(ALB)level,and the curative effect of TCM was evaluated according to TCM syndrome score.At the same time,the levels of renal function[blood urea nitrogen(BUN),serum creatinine(SCr)levels],lipid metabolism[triglyceride(TG),total cholesterol(TC)],proteinuria[24 hUP,urinary al-bumin creatinine ratio(UACR)],ALB,anti-PLA2R antibody were compared between the two groups before treatment and 3 months after treatment,and adverse reactions were recorded.Results After 3 months of treatment,the levels of UACR,BUN,SCr,24 hUp,TG,TC,and anti-PLA2R antibody in the two groups were lower than those before treatment,the level of ALB was higher than that before treatment,and the scores of fatigue,edema,cold limbs,waist and knee soreness,abdominal distention and total score were lower than those before treatment,after 3 months of treatment,the levels of UACR,BUN,SCr,24 hUp,TG,TC and anti-PLA2R antibody in the observation group were lower than those in the control group,the level of ALB was higher than that in the control group,and the scores of fatigue,edema,cold limbs,waist and knee soreness and total score in the observation group were lower than those in the control group,and the differences were sta-tistically significant(P<0.05).There was no statistically significant difference in abdominal distension score between the two groups after 3 months of treatment(P>0.05).The total effective rate of western medicine in the observation group was 92.45%,which was higher than 77.36%in the control group,and the difference was statistically significant(P<0.05).The total effective rate of TCM syndromes in the observation group was 88.68%,which was higher than 67.92%in the control group,and the difference was statistically signifi-cant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Jiawei Jianshen decoction combined with tacrolimus is effective in the treatment of IMN,which can improve the clinical symptoms,BUN,SCr,anti-PLA2R antibody and other indi-cators.