The Changes Of Serum Cystatin C Before And After The Combined Use Of Traditional Chinese Medicine And Western Medicine To Treat The Early Metaphase Diabetic Nephropathy And Clinical Significance

BackgroundDiabetes nephropathy(DN)is one of the common chronic capillaries complications of diabetes mellitus,is the important cause of death in diabetes mellitus.Moreover its incidence shows an upward tendency year by year,the majority of diabetes nephropathy patients will develop late renal failure and die of the cardiovascular complications in advance. According to the investigation of the domestic scholar,the morbidity of diabetes nephropathy patients in our country is 33.1%,among of that the early nephropathy is 18%,and holds the very great proportion,if these patients can be treated in the early time,the structure and function of the renal glomerulus can be recovered.So how to diagnose diabetes nephropathy in time,and how to seek one kind of sensitive,accurate, simple,reliable parameter which can reflect early renal disfunction,had been a problem which is used to be solved as soon as possible in clinic.The glomerular filtration rate(GFR)is an objective index which can reflect the filtration function of the renal glomerulus in clinic.Cys C also be called serum cystatin C,its generate concentration stabilize,and its production rate will not be effected by the age,sex,tumor,immunity and endocrinous factor.It is an ideal endogenous parameter which can effect the change of GFR.The study of contemporary traditional Chinese medicine(TCM)indicate the pathogenesis of diabetes is yin asthenia and dryness-heat,its fundament is yin asthenia,its appearance is dryness-heat,and diabetes happens to change easily with stagnated blood and pathogenic damp,DN which is secondary to diabetes and cause multiple organ disfunction,and its finally result is asthenia healthy qi and sthenia pathogenic factor syndrome,at present the domestic scholars have not unified view with regard to the patbogenesis and typing of DN,but the typing of early stage is divided to deficiency of both vital energy and yin and asdthenic splenonephro-yang(qi),and because of the protracted pathogenesis,the stagnated blood must exit in any stage of the disease.So supplementing qi and nourishing yin,invigorate the spleen and the kidney,activating blood circulation to dissipate blood stasis are the main treatment of DN.ObjectiveThrough to observe the change of Cys C before and after the treatment from the patients who use traditional Chinese medicine and western medicine to treat,observe the dependability of the symptom of TCM and DN,.Further more,evaluate the effect of the treatment group.And finally find a available schedule to treat the early DN and find a new parameter which can reflect GFR.MethodsA total of 60 qualified patients were randomly divided into treatment and controlled groups using a table of prospective clinical observation, apply database and statistical analysis technology to study,during to calculate sample size and analyze actual condition,finlly to summarize conclusion.ResultsIn the score of Chinese medical symptom,comparing the treatment and controlled groups before and after treatment,the symptoms of the patients are all conspicuously improved(p＜0.01),and the treatment group is superior to controlled group(p＜0.01 or p＜0.05).Comparing blood glucose, there was no difference in fasting blood glucose and postprandial blood sugar after therapy in two group(p＞0.05),the biochemical indicators all improve after therapy in treatment and controlled group,among that there was significant difference in Cys C Scr and MALB(p＜0.01),furthermore the level of index in treatment group is better than the controlled group(p＜0.01 or p＜0.05).In the dependability analysis,the finding indicates Cys C,Scr and MALB submit direct correlation in two group,the dependability of Cys C and MALB was more complete,there is significant difference compared with Scr(p＜0.05).ConclusionThrough the research,the clinical symptoms of DN were conspicuously improved with using combination of TCM with Western medicine,for instance hydrodipsia,hypodynamia and so on.Through detecting the level of serum cystatin C,Scr,MALB and comparing each other,Cys C which is used to be a parameter of evaluating early renal disfunction is better than Scr, and contrasting with MALB,because of Cys C is convenient and quickly to detect,and wasn't affected by non-renal factor,So serum cystatin C is a convenient,accurate,reliable parameter to evaluating renal disfunction of early metaphase DN.Comparing with treatment group and controlled group,we can find the therapy of combination of TCM with Western medicine can reduce the level of Cys C effectually and is better than Western medicine.