Objective

2

To evaluate the efficacy and safety of

Mafu Yishen Decoction

in the treatment of intermediate- and high-risk membranous nephropathy （MN） with external cold and internal deficiency， cold coagulation， and stasis accumulation syndrome through a real-world study.

Methods

2

Clinical data were collected from intermediate- and high-risk MN patients who received

Mafu Yishen Decoction

treatment at the Department of Nephrology， Beijing Hospital of Traditional Chinese Medicine， between 2016 and 2022. The primary outcome was a composite endpoint of complete or partial remission. Secondary outcomes included 24-hour urine protein quantification （UTP）， serum albumin （ALB）， serum creatinine （SCr）， estimated glomerular filtration rate （eGFR）， and other clinical manifestations of nephrotic syndrome.

Results

2

①A total of 152 MN patients were included， comprising 36 with intermediate risk and 116 with high risk. The median treatment duration was 48.0 （34.8，63.6） months.② After

Mafu Yishen Decoction

treatment， 75.7% （115/152） of patients achieved clinical remission， including 29.6% with complete remission and 46.1% with partial remission. The cumulative remission rates at 12， 24， 36， and 48 months were 30.9%， 55.9%， 66.4%， and 73.0%， respectively.③ Relapse occurred in 10.4% （12/115） of patients during follow-up； the time from remission to relapse was 14.5 （7.5，22.5） months. ④ After treatment， serum ALB increased from 26.0 （22.4，30.2） g/L to 40.2 （34.6，44.1） g/L （

P

<

0.01）， 24-hour UTP decrea

sed from 7.5 （5.0，10.2） g to 1.1 （0.1，3.9） g （

P

<

0.01）， and blood lipid levels significantly decreased （

P

<

0.01）.⑤ No significant adverse reactions were observed during

Mafu Yishen Decoction

treatment.

Conclusion

2

MaFu YiShen Decoction

can effectively improve the clinical symptoms and nephrotic syndrome status of patients with MN

yang

deficiency and symptomatic syndrome， with high safety and low recurrence rate. This therapy has the value of popularisation and application in clinical practice.