RESUMO
Objective:To evaluate the curative effect of Moshen Decoction combined with routine western medicine on idiopathic membranous nephropathy (IMN) of spleen-kidney qi deficiency syndrome and explore its influences on renal function, C1q, PLA2R and E-cadherin levels.Methods:A total of 62 patients with IMN meeting inclusion criteria in the hospital were enrolled between January 2018 and January 2021. According to simple random grouping method, they were divided into control group (hormones combined with cyclophosphamide) and observation group (Moshen Decoction on basis of control group), 31 in each group. Both groups were treated continuously for 6 months. Before and after treatment, TCM syndromes were scored. The levels of blood urea nitrogen (BUN), serum creatinine (SCr), cystatin C (Cys-C), anti-phospholipase A2 receptor (PLA2R) and E-cadherin (EC) were detected by ELISA. The level of serum complement C1q was detected by immunoturbidimetry. The 24 h urine was collected for quantitative determination by full-automatic biochemical analyzer. The adverse events during treatment were observed and recorded. And clinical curative effect was evaluated.Results:The differences in total response rate between observation group and control group were statistically significant [93.55% (29/31) vs. 74.19% (23/31); χ2=4.29, P=0.038]. After treatment, scores of TCM syndromes (edema of lower limbs, fatigue and poor appetite, lusterless complexion) in observation group were significantly lower than those in the control group ( t=10.07, 10.80, 4.34, 4.57, P<0.001). After treatment, levels of serum Cys-C [(0.51±0.05) mg/L vs. (0.55±0.06) mg/L, t=2.85], 24 h urine protein quantification [(0.95±0.19) g vs. (1.38±0.23) g, t=13.32] in observation group were lower than those in the control group ( P<0.01), and levels of serum PLA2R [(17.53±1.84) Ru/ml vs. (19.62±2.05) Ru/ml, t=4.22], EC [(2.74±0.26) μg/L vs. (3.05±0.37) μg/L, t=3.82] and complement C1q [(152.34±15.62) mg/L vs. (169.33±16.77) mg/L, t=4.13] in observation group were significantly lower than those in the control group ( P<0.01). During treatment, there was no significant difference in incidence of adverse events between observation group and control group [12.90% (4/31) vs. 16.13% (5/31); χ2=0.13, P=0.781]. Conclusion:Moshen Decoction combined with routine western medicine can improve renal function and clinical curative effect in patients with IMN of spleen-kidney qi deficiency syndrome. Its mechanism of action may be related to reducing urine protein, complement C1q, PLA2R and EC.