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Adjuvant treatment of kidney Huoxue clinical observation of 48 cases of diabetic nephropathy


Chinese papers League finishing. Diabetic nephropathy (DN) in diabetic (DM) common microvascular disease, diabetes is a major cause of death of disability. Delay or prevent the progress of DN, has important clinical significance. In recent years, conventional treatment in western medicine based on the use of Chinese medicine treatment of clinical stage Yishenhuoxue (Ⅳ of) DN48 patients, and treatment with Western medicine alone were 30 cases, and achieved good effect, the report is as follows. 1 clinical data 78 patients with type 2 diabetes are in line with 1997, the American Diabetes Association (ADA) diagnostic criteria for diabetes [1], and in accordance with Mogensen staging criteria [2] , the clinical stage (Ⅳ of) DN [24h urine albumin> 30mg or 24h urine protein (Pr) quantitative> 0.5g]. All cases were excluded from primary glomerular disease and hypertension, renal arteriosclerosis, etc., causing the other secondary glomerular diseases. Selected cases were 78 cases of advance diuretic, antihypertensive, anti-infection and symptomatic treatment after 1 week were randomly divided into two groups. Treatment group, 48 patients 26 male and 22 female; aged 36 to 70 years, mean (59.3 ± 8.6) years; DM course of 4 to 17 years, the average (10.8 ± 3.7) years, DN duration of 2 months to 6 years average (2.8 ± 1. years; 36 patients with hypertension, edema in 30 cases, renal insufficiency in 28 cases. Control group of 30 patients, 19 males and 11 females; aged 35 to 69 years with a mean (61.8 ± 7.4) years; DM course of 3 to 18 years, the average (10.2 ± 4.5) years, DN course of 1 month to 5 years average (2.4 ± 1.6) years; 21 patients with hypertension, edema in 17 cases, 15 cases of renal dysfunction. The clinical data of the two groups, the difference was not significant (P> 0.05). 2 treatment and observation methods 2.1 treatment groups were utilized, are high-quality low-protein diabetic diet, adequate exercise, proper oral glucose peace (or) insulin treatment of the same, captopril 6.25 ~ 25mg orally 3 times a day. The treatment group was based on the use of Chinese medicine treatment Yishenhuoxue: Astragalus 30g, Dodder 15g, cornus 10g, Chinese yam 15g, Atractylodes fried 15g, angelica 15g, Salvia miltiorrhiza 20g, leech 10g, Rhubarb 10g . Yin deficiency add raw land, Anemarrhena; Yang who added Aconite, Epimedium; and hot and humid plus Treats, Coix; and moisture are Jiaze diarrhea, Plantago. Will be concentrated decoction of the drugs, take liquid 300ml, 2 times, warm clothes , day 1. The treatment lasted 3 months. OUTCOME MEASURES 2.2 Determination of fasting blood glucose before and after treatment (FBG), serum creatinine (SCr), blood urea nitrogen (BUN), serum albumin (AIb), ​​serum cholesterol ( TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C), 24h urinary protein and blood rheology were measured. 2.3 statistical methods using t test measurement data, count data using χ 2 test. 3 treatment results 3.1 evaluation standard reference Ministry of Health, Markedly effective: Clinical symptoms and signs disappeared, FBG <7.2mmol / L; 24h urinary protein <0.3g, or decrease 1 / 2 ; renal function, or SCr decreased by 1 / 3. Effective: Clinical symptoms and signs to reduce, FBG <8. 3mmol / L; 24h urinary protein 0.3 ~ 2.0g, or decrease 1 / 3; SCr declined. Invalid : clinical symptoms and signs no improvement, laboratory tests did not achieve effective standards or worse. 3.2 The treatment groups were compared two groups of 48 cases, effective in 20 cases (41.7%), effective in 23 cases (47.9%), ineffective in 5 cases (10.4%), total effective rate was 89.6%; control group, 30 patients were cured, 6 (20.0%), effective in 13 cases (43.3%), ineffective in 11 cases (36.7%), the total effective rate was 63.3%. The total effective rate, the difference was significant (P <0.01). 3.3 before and after treatment FBG,[link widoczny dla zalogowanych], 24h urinary protein, serum BUN, SCr, changes in plasma A lb compare Table 1 shows , before and after treatment, FBG, serum BUN, SCr, serum Alb, 24h urinary protein comparison, the differences were very significant (P <0.05 or P <0.01); control group FBG, 24h urinary protein before and after treatment, the difference was significant (P <0.05 or P <0.01); treatment indicators Comparing the treatment group than the control group, the difference was significant (P <0.05). 3.4 before and after treatment lipid, compared hemorheology Table 2 , Table 3 shows, before and after treatment, blood lipids, blood rheology, the difference was significant (P 0.05). Comparison of the indicators after the treatment, the treatment group than the control group, the difference was significant (P <0.05). 4 discussions the pathogenesis of diabetic nephropathy more complex, is generally believed that the metabolic and endocrine disorders , hemodynamics, microvascular structural damage, genetic and other factors. Delayed healing of diabetic nephropathy is diabetic, developed from the course of time, is a traditional Chinese medicine, Pathogenesis of many of its deficiency in the spleen and kidney, based on the gasification of the Division lost due to poor blood circulation, blood stagnation in renal network, renal failure sealing possession Guse, subtle bet made. Therefore, we focused on the disease Dabu strength prescription Astragalus, Atractylodes spleen Sun, dodder seed, Chinese yam, cornus kidney Yin Lian Qi, Wang to help temper the blood line, blood stasis and subtle self-cured solid. Modern pharmacological studies have shown that the beneficial traditional Chinese medicines can lower blood sugar, strengthen the metabolism, enhance and regulate immune responses; Astragalus to prevent or reverse the role of proteinuria, can inhibit renal NO generation, can partially correct the abnormalities of early diabetic renal hemodynamics [4]. Salvia, Angelica, leeches and other blood circulation, dredge the renal network, to facilitate the blood fluid to run, inhibits platelet aggregation, reduce blood viscosity, fibrinolytic activity to promote and improve the renal microcirculation, the development of renal failure such as the role [5,6]. Rhubarb dampness heat, promoting blood circulation down and dirty, can significantly improve renal function in DN rats, inhibition of renal hypertrophy, reduced proteinuria, improved lipid metabolism, lowering blood glucose [7]. Angiotensin-converting enzyme inhibitors can not only effectively lower blood pressure, and can ease the glomerular filtration of high status and high transmembrane pressure, reduce proteinuria , slow the progress of renal damage, is the primary drug of Western medicine treatment of DN. This observation indicated that, on the basis of in western medicine with traditional Chinese medicine clinical Yishenhuoxue of DN, the total effective rate was significantly better than that of the control group with western medicine, Integrative Medicine can significantly reduce or eliminate the clinical symptoms of diabetes, delaying renal the progression of decline.