Study On Community-based Intervention By Traditional Chinese Medicine(TCM)on High Risk Groups Of Chronic Kidney Disease (CKD)

Objectives After screening high-risk groups of chronic kidney disease (CKD) in community, the high-risk groups were intervened with TCM appropriate technology and integrated interventions based on health-ecology model. To evaluate the effects of the intervention conducted in high-risk groups of CKD, and to provide research results and theoretical basis for CKD health management of high-risk populations in urban community.Methods ①By community-based intervention trial method the study group were received TCM comprehensive intervention. Changes and improvement were observed of compliance rates, urinary albumin control rate and CKD risk factors (blood pressure, BMI)ect;②To design and write a booklet Early Kidney Disease Prevention Knowledge in Community,and to educate the intervention group, to improve the comprehensive prevention and treatment knowledge, and to promote the formation of healthy behaviors;③By the questionnaire, family support scale, TCM comprehensive intervention record sheet, early CKD prevention knowledge questionnaire, to evaluate early CKD prevention knowledge, family living environment, improvement of psychological states.Results ①Compliance rates of intervention group participants is 76.63%;②Overall effective rate of urinary albumin 84.78%, and reduction of intervention group is more than the control group and there is a significant difference between the two groups (t=2.0503,P<0.05). By repeated measures ANOVA there is a significant difference of urinary albumin means between the intervention group and control group(F=16.613,P<0.05), which showed with intervention time, the cumulative effect of intervention group was more obvious;③CKD Risk factors:after 6 months intervention, systolic blood pressure of intervention group dropped to 128.62± 7.18mmHg, diastolic blood pressure dropped to 78.31±5.01mmHg, and fasting plasma glucose decreased to 6.01±1.53mmol/L, while the three indexes of control group raised compared to previous;④CKD prevention knowledge and awareness: after 6 months intervention, the score of basics prevention knowledge, ecological knowledge and TCM comprehensive treatment knowledge of intervention group improved than before, the difference was significant (P<0.01), while the score differences between two groups were significant compared to the basic of control group, (t=4.39, P<0.01, ecology intervention knowledge, t=5.77, P<0.01); ⑤Improvement of ecology environment:after 6 months intervention, the difference of intimacy, emotional expression in intervention group were significant (t=2.1529,3.9340, P<0.05) compared with previous measurement, but there were no significan difference of intimacy, emotional expression in control group compar-ed with previous measurement (P> 0.05)⑥Improvement of psychological status:6 months after the intervention, mental state of intervention group improved significantly(63.04% of people), which was significantly better than the control group (15.24%). There is a significant difference between the two groups by chi-square test.Conclusion In the early stages of CKD, there may be no symptoms. Most high-risk population of CKD know little about CKD prevention knowledge, but once suffered from chronic end stage renal disease the patients will face to high risk of disability, death and heavy disease burden. The study showed that after TCM comprehensive intervention, urinary albumin, chronic kidney disease risk factors (blood pressure, blood sugar, BMI index) were all decreased; awareness of CKD prevention knowledge was raised; family ecology environment and mental state were improved. It found the effect could last with follow-up.Therefore the implementation of integrated TCM intervention community-based programs for CKD high-risk groups can prevent or delay CKD, which has some social significance, and it can reduce not only the disease burden of patient and family, but also the social and economic disease burden.