Efficacy of Traditional Chinese Medicine Regimen Jian Pi Qu Shi Formula for Refractory Patients with Idiopathic Membranous Nephropathy: A Retrospective Case‐Series Study

Abstract

Background The treatment of adult refractory idiopathic membranous nephropathy with steroid and other immunosuppressant-resistant nephrotic syndromes can be a significant challenge. We evaluated the efficacy and safety of the traditional Chinese medicine Jian Pi Qu Shi Formula (JPQSF) as a promising regimen. MethodsWe analyzed 15 consecutive patients with biopsy-proven idiopathic membranous nephropathy who failed immunosuppressive therapy from October 2013 to January 2017. JPQSF was administered orally two times per day, respectively, in the morning and at night for 6 months. All patients had at least 1 year of follow-up. The primary endpoints included complete or partial remission. Secondary endpoints included change of clinical parameters and adverse events after 12 months of treatment. Results After 12 months, complete remission was achieved in 13.3% of patients and partial remission in 66.7%, yielding a response rate of 80%. Proteinuria, serum albumin, and cholesterol were improved significantly (P<0.001, P<0.001, and P<0.05, respectively). After 1 year of treatment, proteinuria (mean ± SD) decreased from 5.93 ± 2.54 g per 24 h to 1.99 ± 1.17 g per 24 h (P<0.001). No serious adverse events occurred during the observation. Conclusions JPQSF may be an alternative therapeutic option for steroid and general immunosuppressant-resistant membranous nephrotic syndrome patients, with a favorable safety profile. Larger and longer follow-up studies evaluating this regimen are warranted.

How Does Herbal Medicine Treat Idiopathic Membranous Nephropathy?

“…The findings demonstrated that Shenqi particle was a promising alternative therapy for adults with IMN and nephrotic syndrome (Chen et al, 2013). In addition, it has been reported that 15 patients who fail to immunosuppressive therapy treated with Jianpiqushifang, and found that 80% of the patients were able to achieve clinical remission, and no obvious adverse reactions were found after 1 year of follow-up (Shi et al, 2018). Recently, the combination of tripterygium wilfordii multiglycosides and prednisone is considered as an effective and safe therapy for IMN.…”

“…In addition, herb medicine were used for the treatment of CKD by modulating the metabolic disorders such as amino acid metabolism and lipid metabolism ( Zhang et al., 2018 ; Miao et al., 2020 ). A number of studies have demonstrated that herbal medicine could be used for the treatment of IMN ( Xu et al., 2015 ; Shi et al., 2018 ; Wang et al., 2018c ; Jin et al., 2020 ). In Table 1 , we summarized the reports on the treatment of IMN with herbal medicine.…”

Jianpi Qushi Heluo Formula Alleviates Renal Damages in Passive Hemann Nephritis Rats by Upregulating Parkin-Mediated Mitochondrial Autophagy

“…JQHF, a traditional Chinese compound formula, has been used to treat MN for several years at Xiyuan hospital. We previously reported that for patients whit refractory MN, after a treatment period of 6 months by JQHF, the clinical remission rate was 80% and without apparent side effects [6]. The safety and e cacy of JQHF have been proved by clinical trial, but the speci c mechanism of JQHF in MN is still unclear.…”

“…Professor Yu has treated MN patients with TCM for more than 20 years and accumulated a large number of theoretical and clinical experience. A clinical study reported that for patients with refractory MN, after a treatment period of 6 months by JQHF, the clinical remission rate was 80% and without apparent side effects [6]. However, the exact mechanism of JQHF on the progression of MN is still unknown.…”

Jianpi Qushi Heluo Formula alleviates renal damages in Passive Hemann nephritis in rats by upregulating Parkin-mediated mitochondrial autophagy

“…Professor Yu has treated MN patients with TCM for more than 20 years and has accumulated much theoretical and clinical experience. A clinical study reported that for patients with refractory MN, after a treatment period of 6 months by JQHF, the clinical remission rate was 80% and without apparent side effects 6 . However, the exact mechanism of JQHF on the progression of MN is still unknown.…”