The Study Of Clinical Research On 3,4 Stage Diabetic Nephropathy Treatment By Nourishing Spleen, Boosting Kidney And Stimulating Blood And Qi Circulation Method

ObjectiveThrough self-controlled clinical efficacy of spleen and kidney, Qi and blood circulation Treatment of diabetic nephropathy (Ⅲ, Ⅳ stage).MethodThe method uses self-controlled, the number of cases included 30 cases. All enrolled patients received basic treatment such as Diabetes diet, Low levels of high-protein, Low fat and salt diet, quit smoke and alcohol drinks. If the patient has a subcutaneous injection of insulin or oral hypoglycemic agents to control blood sugar to reach FPG<8mmol/L or 2hPG<12mmol/L. And avoid using oral hypoglycemic drugs renal impairment. Strictly control blood pressure and try to keep random blood pressure lower than 150/90mmHg. On the basis of the treatment, the addition of spleen and kidney, qi and blood circulation decoction. Prescription composition by Radix Astragalus 30g Radix Fici Hirtae 30g Atractylodes macrocephalea 20g Poria cocos 30g Radix dipsaci 15g Rhizoma cobotii 15g Fructose aurantium 10g (Use Citrus aurantium when patients who showed dampness and heat spleen with dry and greasy tongue & white or soft yellow fur) Citrus reticulata 10g (Use Citrus reticulata when patients who showed deficiency and dampness spleen with thick white fur) Peach seed 10g Safflower carthamus 5g. if patient have a chronic renal disease or high serum creatinine 133-300μmol/L or stool less than 2 times per day. Upper prescription can addition Rheum officinale 5g (boiling later) for eliminate waste with purgation. Patients before and after treatment, each take a laboratory test; include Blood sugar, Serum creatinine, Urinary protein, Cystatin C, eGFR. Accept TCM symptoms scores before and after treatment.ResultAfter the patient takes efficacy of spleen and kidney, Qi and blood circulation decoction treatment. TCM symptoms Treatment efficiency markedly 36.66%, effective 43.33%, total efficiency 79.99%. Cystatin C and serum creatinine significant improvement; Cystatin C before treatment 3.112±0.986(mg/L), after treatment 2.506±0.979(mg/L), Serum creatinine before treatment 282.866±75.604(μmol/L) after treatment 225.833± 54.233 (u mol/L). Urinary protein obviously decrease; Micro albuminuria before treatment 3221.1±1105.165 (mg/L), after treatment 2444.333± 1039.417 (mg/L),24h urinary protein before treatment 3.062±1.19(g/24h), after treatment 2.358±1.001 (g/24h), eGFR significant improvement; eGFR before treatment 23.706±7.486(mL/min·1.73m2), after treatment 30.163 ±8.644(mL/min·1.73 m2). The statistical analysis of the above indicators are statistically significant (P<0.05). Clinical Observation no toxic side effects of drugs and adverse reactions.ConelusionThe efficacy of spleen and kidney, Qi and blood circulation treatment of TCM has no toxic side effects of drugs and adverse reactions to Diabetic nephropathy (Ⅲ, Ⅳ stage) patients. Moreover, its can improve TCM symptoms and renal function, decrease urinary protein and serum creatinine. Worth more deeply study.