To investigate the therapeutic effects of tripterygium glycosides combined with mycophenolate mofetil and glucocorticoid on immunoglobulin A (IgA) nephropathy, and to explore the possible mechanism of action involved.

A total of 150 patients with IgA nephropathy admitted to the Second Hospital of Hebei Medical University from May 2020 to June 2022 were enrolled and divided into either a control group (n=75) or an experimental group (n=75) using the random number table methods. Both groups were treated with glucocorticoid. In addition, the control group was treated with tripterygium glycosides, and the experimental group was treated with mycophenolate mofetil combined with tripterygium glycosides. Both groups were treated continuously for 6 months. Before and after treatment, renal function indexes [24-hour urinary protein quantification, serum creatinine (Scr), and urea nitrogen (BUN)], humoral immune indexes [IgA and immunoglobulin G (IgG)], inflammatory factors [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)], and oxidative stress indexes [superoxide dismutase (SOD) and malondialdehyde (MDA)] were detected. The efficacy and each detected index were compared between the two groups, and the adverse reactions were recorded.

In the final study, there were 70 patients in the experimental group and 71 in the control group. The mean age of patients in the experimental group was (42.2±6.2) years, while it was (41.9±5.8) years in the control group. The total effective rate of the experimental group was 95.71%, which was significantly higher than that of the control group (70.28%; P<0.05). After treatment, the levels of 24 h urinary protein, Scr, and BUN were all lower in the experimental group than in the control group (P<0.05 for all). After treatment, the levels of serum IL-6, TNF-α, and MDA in the experimental group were all significantly lower than those in the control group (P<0.05 for all), and the level of SOD was significantly higher than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (18.57% vs 12.68%, P>0.05).

The combination of tripterygium glycosides and mycophenolate mofetil in the treatment of IgA nephropathy has a good effect, which can reduce the inflammatory response and regulate the imbalance of oxidative stress, thereby improving the renal function of patients.