The Clinical Resrarch Of The Strength Spleen Nourishing Kidney And Activing Circulation Method To Treat Early Diabetic Nephropathy

Objective: To valuate the clinical effect of the of strength spleen, nourishing kidney and activating circulation decoction and to treat early diabetic nephropathy and explore its mechanism in order to provide a new way for the treatment of the early diabetic nephropathy.Methods: 135 cases of patiences who were in department of indocrnolegy in Traditional Chinese Medicine Hospital, Hebei Medical University were selected and were diagnosed early diabetic nephropathy in western medicine, belonged to deficiency of spleen and kidney syndrome and stasis blood blocked meridian syndrome in syndrome differentiation types of Traditional Chinese Medicine whose hypertension were normal. All the patiences were randomly divided into three groups: integrated traditional Chinese and western medicine group, Lotensin group and traditional Chinese medicine group. Each group was 45 cases. The age, sex, course of disease individual history, family history and complication of patiences` in each group had no significant difference (P>0.05) and had the valuation to compare. All the patiences received the normal treatment which included the education of diabetes, controlling diet, no smoking and drinking and appropriate movement, at the same time, whose blood glucose was controlled with Novolin 30R or Novolin 50R, the aim was Fasting plasma glucose (FPG) controlled to 3.9~6.5mmol/L 2hPG to 4.4~7.8mmol/L.Beside the normal treatment, integrated traditional Chinese and western medicine group was added strength spleen, nourishing kidney and activating circulation decoction and Lotensin, Lotensin was added to Lotensin group, the strength spleen, nourishing kidney and activating circulation decoction was added to traditional Chinese medicine group. One does a day, which was divided into two parts, and was put into two bags separately, each bag was filled with 150ml. The soup produced by Traditional Chinese Medicine Hospital, Hebei Medical University. Which was drunk an hour before breakfast and supper. The standard content of each Lotensin is 10mg, provided by Beijing Nuohua Pharmaceutical limited Company. The treatment time was two months, in the course, the patiences were prohibited to have dissolve thrombus and resisting coagulum medicine, or else, they would be rejected.The patiences'Chinese syndrome scores were calculated before and after the treatment, at the same time, UAER in 24 hours, BP, FPG, 2hPG, HbA1c, TC, TG, HDL-C,LDL-C, ALT, r-GT, BUN, Cr, blood density, Hct, Fbg, PAI-1, ET and serum NO. Results: For some reason 15 patiences left the experiment during the treatment and the end number of patiences was 120, integrated traditional Chinese and western medicine group was 42, Lotensin group was 40, and traditional Chinese medicine group was 40.1 Comparison of treatment effect of early diabetic nephropathy.The total effectivity of integrated traditional Chinese and western medicine group was 90.48%, which of Lotensin group was 73.68% and which of traditional Chinese medicine group was 85.00%.The comparison between traditional Chinese medicine group and Lotensin group had significant diference (P<0.01).2 Comparison of effect of traditional Chinese syndromeThe total effectivity of integrated traditional Chinese and western medicine group was 92.86%, which of Lotensin group was 78.96% and which of traditional Chinese medicine group was 90.00%. Through statistical analysis, the difference among the three groups was significant(P<0.05). The comparison between traditional Chinese medicine group and Lotensin group had significant diference (P<0.01). The comparison between traditional Chinese medicine group and integrated traditional Chinese and western medicine group had no significant diference (P>0.05).3 Comparison of individual event syndrome score before and after treatment. The change of the individual event syndrome score of three groups before and after treatment had significant difference. integrated traditional Chinese and western medicine group and traditional Chinese medicine group had no significant difference (P>0.05), while the two groups had significant difference compared with Lotensin group (P<0.01).4 Comparison of the change of UAERWith statistical analysis, the change of three groups UAER before and after treatment was significant different. Integrated traditional Chinese and western medicine group (P<0.01), Lotensin group (P<0.05), traditional Chinese medicine group (P<0.01). The result of comparison between integrated traditional Chinese and western medicine group and traditional Chinese medicine group had significant difference (P<0.01). The result of comparison between traditional Chinese medicine group and Lotensin group had significant difference (P<0.01).5 Comparison of hemorheology and blood lipidsThe result of statistical analysis showed, the hemorheology index of the traditional Chinese medicine group, before and after treatment, had significant difference (P<0.01).Compared with Lotensin group and integrated traditional Chinese and western medicine group, had significant difference(P<0.01). In changing blood lipids, the result was same to the former.6 Comparison of ET, serum NO and PAI-1 The result of statistical analysis showed, after treatment ET level of the traditional Chinese group dropped sharply(P<0.01), the level of serum NO increased significantly (P<0.01), and PAI-1 level dropped sharply(P<0.01),compared with Lotensin group ET level had no significant difference(P>0.05),NO level and PAI-1 level had significant difference(P<0.01).Compared with integrated traditional Chinese and western medicine group ET level NO level and PAI-1 level had significant difference(P<0.01).7 Comparison of usage of insulin and criterion time With statistical analysis, in usage of insulin and criterion time, the comparison integrated traditional Chinese and western medicine group and traditional Chinese medicine group had no significant difference (P>0.05), but they had significant diference compared with Lotensin group(P<0.01).8 Comparison of safetyIn the treatment course, the patiences'liver function, kidney function and BP were normal, the treatment of which before and after treatment had no significant difference (P>0.05).Conclusions1 Through the clinical observe of the 120 cases early diabetic nephropathy, the strength spleen, nourishing kidney and activating circulation decoction can drop the UREA of early diabetic nephropathy patiences'.2 The strength spleen, nourishing kidney and activating circulation decoction can improve traditional Chinese syndrome, hemorheology and blood lipids, raise serum NO level, decrease ET and PAI-1level increase the min circulation of part of kidney and protect kidney function.3 The strength spleen, nourishing kidney and activating circulation decoction can strengthen the patiences'sensitivity to insulin, decrease the amount of insulin used, adjust the disorder of sugar metabolize quickly.