Astragalus Angelica Mixture Curative Effect Of Traditional Chinese Medicine In Patients With Chronic Kidney Disease (ckd) 3 To 4 Targets

Research background:Institute of astragalus angelica mixture is compound mixture medicines,which is founded by a professor named Wang shuhe who comes from Peking University first hospital,according to TCM "angelica blood tonic soup".The Peking University institute of kidney disease have researched it for years,they have preliminary confirmed that astragalus angelica mixture can improve protein and lipid levels in patients with nephrotic syndrome;Can inhibit the aristolochic acid nephropathy, obstructive nephropathy fibrosis factors expression(such as the conversion factor is generated TGF-β, connective tissue formation factor, CTGF),monocyte chemotactic protein1(MCP-1) and reduce accumulation of the extracellular matrix; Increase the activity of nitric oxide synthase and anti-oxidation ability, improve renal ischemia state; they have found the other2effective parts of astragalus angelica mixture and24kinds of compounds, which may be related to the permeability of vascular endothelial cells and red cell membrane protection, enhancing immunity, resisting myocardial cell apoptosis, and so on. That is to say astragalus angelica mixture has the positive significance in regulating muscle protein, regulating blood lipid levels, adjusting the ferulic acid sodium and endothelin levels, reducing proteinuria, renal tubular function, prevention of renal glomerular sclerosis and interstitial fibrosis treatment and protecting renal function. Although modern medicine for chronic kidney disease has a systematic in pathological physiology, diagnosis and treatment scheme, yet it is not satisfied for chronic kidney disease treatment effect. People have got the approval that traditional Chinese medicine may play an important role in diagnosis and treatment of chronic kidney disease. Astragalus angelica mixture has therapeutic effect on chronic kidney disease (CKD), while the medical effect mechanism and the research target is not so much. Based on the above background, we carried out this trail supported by capital medicine development fund to explore the research targets on curative effect of the astragalus angelica mixture in patients with chronic kidney disease stage3or4patients.This article is part of the project’s research about traditional Chinese medicine.Research purposes:To explore the relationship among chronic kidney disease, chronic kidney disease (CKD) stage and TCM syndrome types and symptoms; To study the targets of TCM syndromes related to the efficacy of astragalus angelica mixture.Materials and methods:The first part of this trail:Firstly,we manipulated a cross-sectional survey in211cases of patients with CKD (chronic kidney disease).All of the patients were from the outpatient and inpaticnt ward of China’s traditional Chinese medicine academy of sciences guanganmen hospital and the first hospital of Peking University, in line with the KDOQI about CKD3-4diagnostic criteria, and the patients were informed and consent before participating in this study. During the study period, recorded211cases of patients’ chronic kidney disease (CKD) stage and the primary diseases leading to chronic kidney disease (CKD). According to "the guiding principle on Chinese traditional medicine new drug clinical research-2002edition", version6diagnostics of traditional Chinese medicine to develop the schedule of survey for patients with chronic kidney disease (CKD) to determine the patients’ TCM syndrome types and observe the changes of syndromes. Results showed:1. Male’s mean age is49.98+/-16.79years old in this study, while women with an average age of56.06+/-14.25years old, the ratioBetween male and female is1:1.5,(p<0.05).2.94.3%(199people) of patients in211patients are of qi deficiency, qi deficiency that is the most common syndromes of CKD3-4patients.2. Both qi and Yin deficiency syndrome, qi deficiency syndrome and spleen and kidney deficiency syndrome are main syndromes about chronic kidney disease (CKD), qi and Yin deficiency patients have hot-humid and turbidity-toxin exprance. qi-blood deficiency have blood-stasis experance. Glomerulonephritis is of qi and Yin deficiency, renal tubular diseases is mainly of spleen-kidney deficiency, renal damage on hypertension is mainly of both qi and blood stasis syndrome (P<0.05)with statistical significance.the second part of the trail:take the32cases of patients who came from the first hospital of Peking University, Chinese academy of sciences guanganmen hospital and dongzhimen hospital,with regular follow-up from July2011to May2013, into astragalus angelica study, and the patients were all informed and consent to participate into the trail.The patients all recepted step-down, blood proteins, correction of anemia, correct acidosis, regulating metabolism of calcium and phosphorus therapy,on the basis above, taking astragalus angelica mixture for3months, and continue a follow-up after the end of the treatment for3months. we recorded general information of0.1.2.3.6. Months(including blood pressure, body weight, accidents, etc.) and serum creatinine, uric acid and renal damage of laboratory indexes such as early, record the patients’ TCM syndrome at every point.At the aspects of chronic kidney disease (CKD) stages and primary diseases we make a evaluation about the associated-significance between glomerular filtration function and the change of syndromes of patients.Research conclusions:1.The overall effective rate of astragalus angelica mixture74.81%(25/32)in CKD3-4patients.After3months treatment,It can make a13.84%drop in overall Scr participants; cGFR increased21.14%.2.Compared to glomerulonephritis and tubule interstitial disease, effect for the patient of renal damage related to high blood pressure is better.3.Different CKD stages do not affect the treatment of astragalus angelica mixture.4.Compared with other syndromes, astragalus angelica mixture has good curative effect for patients with chronic kidney disease (CKD)who are of two qi stasis.5.Astragalus angelica mixture’s treatment for3months in patients have improvement action for qi deficiency, blood deficiency, Yang deficiency, blood stasis.6.Astragalus angelica mixture’s treatment for3months can improve the kidney filtration function (eGFR), and eGFR of patients in CKD3-4and which is associated with the improvement at qi deficiency syndrome aspect.