有效防治特发性膜性肾病(IMN)，是减少本病进展至终末期肾病的最关键策略。本病发病焦点在中医病机与脾肾阳虚有关；在组织学与肾小球足细胞受损伤有关；在分子生物学与足细胞的抗原决定簇暴露成为自身抗原致抗原抗体复合物反应有关。目前研究发现M型磷脂酶A2受体（PLA2R）是IMN的靶抗原，而本病治疗尚无特效药，前期研究结果显示中医温阳利水法疗效好。本项目旨在探讨PLA2R与IMN脾肾阳虚证的关联及温阳利水法的作用机制。通过临床研究探讨IMN患者脾肾阳虚证与PLA2R的关联，有利于中医客观地微观地认识IMN的实质，为中医药辨证论治IMN开创治疗思路和提供理论依据。又借助细胞分子生物学探讨脾肾阳虚证IMN患者血清对足细胞结构和凋亡的影响及温阳利水法的作用机制，为寻找靶向性更强的治疗方法提供实验依据，为进一步开展中医药防治本病奠定基础。

Optimum treatment of idiopathic membranous nephropathy (IMN) plays a pivot role in reducing the risk of end-stage renal disease. The progression of IMN is due to Spleen and Kidney Yang deficiency in TCM theory. At the centre of the pathogenesis of IMN is the damage of a podocyte. On a molecular level, podocyte-membrane proteins are prone to serve as targets for immune-complex formation, which first requires identification of the pathogenic antigen(s). Recently, researchers proved the M-type phospholipase A2 receptor (PLA2R) as the target autoantigen of IMN. However, there is no specific medication for PLA2R. Our early studies suggest that the therapy of Warming Yang and Diuresis would be prospective for the disease. This project mainly characterized by investigating the relationship between PLA2R and syndrom of Spleen and Kidney Yang deficiency of IMN and the mechanism of Warming Yang and Diuresis therapy. Using data from clinical cases, the study is to detect the relevance between PLA2R and Syndrome of Spleen and Kidney Yang deficiency, to clarify the pathogeny of TCM microscopically , and to broaden options of TCM therapy based on modern evidence. By molecular biological methods, we investigate the mechanism of Patient's serum extracted from syndrom of Spleen and Kidney Yang deficiency of IMN affecting the structure and apoptosis of podocytes, together with machanism of Warming Yang and Diuresis therapy. These lab evidence would support more specific target based therapy and possible TCM approaches for IMN prevention and treatment.