Sugar Renal Corning Mixture In The Treatment Of Diabetes Kidney Disease Clinical Observation

ObjectiveDuring in the sugar renal corning mixture in the treatment of diabetes nephropathy (DN) III, IV issue of clinical application, observation sugar mixture treatment of diabetic nephropathy renal corning (DN) III IV period, the clinical curative effect of before and after treatment and β2urine protein, NAG enzyme and plasma homocysteine (HCY) level of change, in order to deeply explore the clinical treatment of diabetic nephropathy early or middle method and Chinese medicine diagnosis and treatment of western united advantages, thus effectively control the diabetes nephrosis illness development deterioration, protect kidney function, and slow down the progress of the renal failure rate and improve the life quality of patients.Material and methodsRefers to the Chinese herbal medicine new medicine clinical research guiding principle (try out)"[1] and the integrated traditional Chinese and western medicine in diabetes diagnosis standard"[2]integrated traditional Chinese and western medicine in China to learn professional committee of the diabetes, the choice III period, Ⅳ DN patients of90patients were divided into treatment group45cases and control in45cases. The control group general treatment, the treatment group with sugar and renal corning mixture,8weeks of treatment, symptoms, blood glucose, and observe the blood fat, urinary albumin excretion rate (UAER), β2-urine protein, NAG enzyme and plasma homocysteine (HCY) level of change, and Homocysteine (Homocysteine, Hey) index and clinical symptoms of change. Results:clinical curative effect in treatment group than in control group (P<0.05).All the90cases of material are from the first affiliated hospital of Zhengzhou University, July2009to February2011in hospital and clinic patients III and IV period of DN. A parallel control, the design of divided into the treatment group in45cases, men in23cases, women in22, age (55±15) years old, the course of (15±10)year, combined with high blood pressure who15patients, retinopathy12cases, combined with the peripheral neuropathy2cases. The control group in45cases, the male20cases, female25cases, age (58±15) years old, the course of (13 ±10), and high blood pressure of19cases, combined with the retinopathy9cases, combined with the peripheral neuropathy in3cases.All patients were diagnosed according to WHO provided diagnostic criteria of the insulin dependent diabetes (MDDM) patients with diabetic nephropathy, and Mogensen diagnosis standard stage, including early diabetic nephropathy51cases, namely urinary albumin excretion rate (UAER) in20to199μ g/min, and rule out other causes urine protein increase factor; Clinical diabetic nephropathy39cases, UAER>200μ g/min, namely urinary albumin discharge amount>300mg/24h, urine protein>0.5g/24h, also need to rule out other causes urine protein increase factors.All the cases are TCM syndrome differentiation is in2002to the Chinese herbal medicine new medicine for the treatment of chronic renal failure of clinical research guiding principle ", determine the kidney empty wet stasis syndrome diagnostic criteria, disease see lumbar debility, languid, dry mouth thirsty, dizzy, or and inspect content fuzzy, of lower limbs micro is swollen, limb pain and numbness, thick coating on the greasy, tongue qualitative or dark purple have petechial hemorrhages seen here, pulse astringent or fine acerbity. Two groups of cases such as age, sex, course index after statistics processing, no significant difference (P>0.05), comparable.Treatment1The control group:foundation treatment; The treatment group:basic therapy plus sugar renal corning mixture;2Treatment time:all patients were two courses treatment of8weeks.3Foundation treatment:(1) Low-protein, low carbohydrate, low fat diabetes diet.(2)To control blood sugar, sugar the original synthesis reduce decomposition increase; Use an oral law by habit is still the oral glucose-lowering drugs or insulin, make the fasting blood sugar maintaining in5.6-6.9mmol/L scope, and make postprandial glucose maintaining low in11.1mmol/L.(3) Blood pressure treatment: use ACEI and/or ARB kind of antihypertensive drugs such as enalaprilat, losartan antihypertensive therapy, to make blood pressure maintain140/90mmHg in the following, if blood pressure control values on the high side or volatile right amount of patients can be increased exposure leels or other types of antihypertensive agents.(4) Maintain water, electrolyte, acid and alkali balance:TongZheng acidosis and lactic acidosis. Permeability diuresis attracted the urine and salt water loss, severe water loss with acidosis. Acidosis serious oral or sodium bicarbonate to static drops.(5) Ban to use of drugs to kidney damage.4Sugar renal corning mixture:Leeches lOg, astragalus membranaceus, danshen each30g, born rehamannia, motherwort, angelica, yumixu every20g, dogberry, medlar, yellow fine root, the15g,3-9g of rhubarb daily agent, and add water to1000ml, fried to300ml, twice clothing.5Main outcome meartures:The two groups were observed records before the treatment and after treatment symptoms, signs of change and record the integral, and about the kidney function change DN some indicators such as urinary albumin excretion rate (UAER), and blood urea nitrogen (BUN), blood both inosine (Ser), P2-urine protein, NAG enzyme, blood fat change indicators such as serum total cholesterol (TC), serum total triglycerides (TG), and plasma homocysteine (Hcy), the hemorrheologic changes, and security observation (blood, urine, dung conventional check liver function, all sorts of complications, the relevant examination electrocardiogram, electromyography, and eye), etc. Above index using conventional methods for testing, all testing index, before and after treatment in the treatment of each test, altogether2times.Data processingAll data by using statistical software SPSS13.0statistical software package processing. Measurement data to mean±standard deviation said, using t-test analysis. P<0.01said have a statistically significance difference between two groups, P<0.05said statistically significant, P>0.05said have no statistical significance. The results1Sugar mixture renal corning joint conventional treatments early or middle of diabetic nephropathy clinical curative effect is:The treatment group in45cases, powerfully16cases, effective23, invalid6cases, the total effective rate of86.7%; The control group45patients, powerfully3cases,10cases effected and32cases are invalid, the total effective rate of28.9%. Two group total effectiveness is statistically significant (P<0.05), the treatment group than in control group.2Before and after the treatment of traditional Chinese medicine treatment symptoms, signs of change and integral change:Add sugar in treatment group renal corning mixture treatment cycle after the end of the signs and symptoms improved obviously, lumbar debility, languid, dry mouth, and of lower limbs micro is swollen, limb pain and numbness, thick coating on the greasy, tongue qualitative or dark purple have petechial hemorrhages seen here and clinical symptoms improved after treatment, symptoms integral contrast before treatment also significantly reduced. The control group only use the conventional treatments and dry mouth, double leg edema, dizzy, or and inspect content such as symptoms of traditional Chinese medicine fuzzy has obviously improved, a statistically significant (P<0.05), and the other symptoms improved obviously, traditional Chinese medicine is not statistically significant (P>0.05). Healing contrast:treatment group than in control group (P<0.05).3The treatment group glycated hemoglobin, urinary protein excretion rate, fasting blood sugar, blood both inosine, urea nitrogen and related indexes in the sugar mixture and foundation treatment for kidney corning combination of contrast statistically significant before and after treatment (P<0.05).The control group glycated hemoglobin, fasting blood sugar related index in the basic conventional contrast statistically significant before and after treatment (P<0.05).The control group urinary albumin excretion rates compared before and after treatment is no statistical difference (P>0.05).The treatment group and control group contrast between curative effect, the treatment group than in control group, a statistically significant (P>0.05).4With sugar renal corning mixture treatment group (32urine protein, NAG enzyme than that of the control group low (P<0.05), protect the kidney function, prevent the illness development worse.5The treatment group of serum total cholesterol (TC), serum total triglycerides (TG), blood rheology and related indexes in the sugar mixture and foundation treatment for kidney corning combination of contrast statistically significant before and after treatment (P<0.05).6Hey to influence:before treatment by the two groups Hey t test has no significant difference (P>0.05). The treatment group after treatment with treatment than before Hey, all declined, a statistically significant (P<0.05); The control group Hey after treatment with treatment than before, are a rising trend, no statistically significant (P>0.05); After treatment, the two groups after treating Hey comparison, a statistically significant (P<0.05), indicating that the treatment group Hey lower than those in the control group.7In the safety index (blood, urine, dung conventional check liver function, all sorts of complications, the relevant examination electrocardiogram, electromyography, and eye) observation, treatment group and control group were not found significant adverse reactions. ConclusionThe experimental results show that:sugar mixture can obviously reduce renal corning DN III period, Ⅳ stage patients (early middle) of patients with fasting blood glucose, glycated hemoglobin, urinary protein excretion rate, blood both inosine, urea nitrogen and may reduce β2urine protein, NAG enzyme and homocysteine numerical, reduce the blood fat, effectively improve patients’ hemodynamic changes, improve the body’s circulation, improve the body function and immunity, protect the renal function, reduce renal damage, effectively relieve the deterioration of the kidney function and reduces the of diabetic macroangiopathy of the risk of complications. At the same time sugar mixture can improve renal corning body lipid metabolism, improve the microcirculation, effectively improve lumbar debility, languid, dry mouth, dizzy, or and inspect content fuzzy, of lower limbs micro is swollen, limb pain and numbness, thick coating on the greasy, tongue qualitative or dark purple have petechial hemorrhages seen here spleen deficiency, such as kidney Yin deficiency of both qi and with phlegm and blood stasis turbidity of traditional Chinese medical syndrome, improve microcirculation kidney, increase oxygen supply and blood supply, improve the metabolism and get their kidneys and self-repairing ability, prevent illness worsens, obviously improved survival quality and body function, and drug safety is high, fewer side effects, symptoms, and has high practical value. Therefore, in clinical application, sugar mixture renal corning diabetic nephropathy early treatment in the middle of one of the effective method.