Clincal Effects of Tripterygium Glycosides Combined with Prednisone on IgA Nephropathy and Its Effect on Urinary Smad2 and TGF-β1

OBJECTIVE To explore the clinical effect of tripterygium glycosides combined with prednisone on IgA nephropathy and its effect on urinary Smad2 and TGF-β1. METHODS A total of 155 IgA nephropathy patients in Quanzhou First Hospital Affiliated to Fujian Medical University were randomly divided into three groups:tripterygium glycosides group(51 cases), prednisone group(52 cases) and combined treatment group(52 cases), among them, 1 case was lost in the tripterygium glycosides group, 2 cases were exit in the prednisone group due to severe infection, and 2 cases were exit in the combined treatment group due to severe infection. In the prednisone group, prednisone was taken orally, tripterygium glycosides group was treated with tripterygium glycosides tablets, and the combined group was treated with 2 drugs at the same time for 12 months. The curative effect of patients was evaluated before and after treatment and the changes of serum creatinine(Scr), epidermal growth factor receptor(eGFR), blood urea nitrogen(BUN), serum uric acid(SUA), serum albumin(Alb), total cholesterol(TC), 24 h proteinuria, Smad2 and TGF-β1 were detected before and after treatment. RESULTS There was no significant difference in eGFR, BUN, SUA, Alb, TC among the three groups before treatment. Compared with before treatment, Alb, eGFR after treatment increased in the three groups(P<0.05), and compared with prednisone group and tripterygium glycosides group, Alb in the combined group after treatment significant increased(P<0.05); Compared with before treatment, BUN and SUA after treatment decreased in the combined group(P<0.05), and there was no significant difference between prednisone group and tripterygium glycosides group, and TC was no significant change before and after treatment. There was no significant difference in urine Smad2 and TGF-β1 among the three groups before treatment. Compared with before treatment, Smad2 and TGF-β1 after treatment decreased in the three groups. After treatment, Smad2 and TGF-β1 in the three groups decreased, and compared with prednisone group and tripterygium glycosides group, Smad2 and TGF-β1 in the combined group after treatment significant decreased(P<0.05). The total effective rate of tripterygium glycosides group was 66.00%, prednisone group was 62.00%, and the combined group was 88.00%(P<0.05). The adverse reaction rate of tripterygium glycosides group was 20.00%, prednisone group was 22.00%, and the combined group was 24.00%. CONCLUSION Prednisone combined with tripterygium glycosides can reduce the expression of Smad2 and TGF-β1 in urine of IgA nephropathy patients, improve renal function of patients. It has a certain clinical value.