The Study Of Early Renal Damage Index Variations Of Wilson's Disease And Of Bu-shen Qu-tan Hua-yu On Early Renal Damage Of Wilson's Disease

Objective:(1)To explore whether there exists early renal damage and change rule of damage index by observing early Glomerular damage index in Wilson disease patients: blood cystatin C(Cys C),urinary immunoglobulin G(UIg G),urinary albumin/creatinine ratio(UACR),urinary transferrin(UTRF)and renal tubular damage index in Wilson disease patients : Urinary ?2-microglobulin(U?2-MG),Urinary?1-microglobulin(U?1-MG),urinary N-acetyl-?-D-glucosidase(UNAG),Urinary Retinol-Binding Protein(URBP).(2)To observe the effect of Bushen Qutan Huayu on Wilson disease patients with early renal damage index,clinical curative effect and safety index,and to evaluate there is clinical curative effect and safety improvement of renal damage by Bushen Qutan Huayu.Methods:(1)The 60 patients were randomly divided into control group and treatment group,30 with DMPS group and 30 adding Bushen Qutan Huayu Chinese herbal medicine+DMPS,a course with 6days,intermittence with 2 days for adding calcium,zinc,iron and other elements,totally 4 courses.To survey renal damage index changes of 60 cases Wilson disease patients and 20 cases healthy people before treatment,and to observe renal damage index,the clinical curative effect and safety index of 2 groups in the same group and between groups before and after treatment.(2)Using SPSS 21.0 analyses data,the result P<0.05 is that difference has statistical significance,P<0.01 is that difference has very significant difference,P>0.05 is that difference has no statistical significance;normal data to expressx±s format,using t test for quantitative data,using the chi square test for count data.Picture drawing with using Graph Pad Prism V5.0 software.Results:(1)Changes of Renal damage index in 60 cases Wilson disease patients;1)Renal tubule damage index: compared with healthy group,U?2-MG?U?1-MG?URBP?UNAG values in Wilson disease patients were higher than those in control group,and the result had statistical difference(P<0.01).2)Glomerular damage indexes:compared with the healthy group,serum Cys C,UIg G,UACR,UTRF values in Wilson disease patients were higher than those of control group,and the result had statistical difference(P < 0.01).3)Blood Cys C index of Wilson disease patients increased with the increase of age.4)The renal tubular and glomerular index average relative added values with healthy group were not statistically different(P> 0.05);Compared with healthy group,average relative added value in renal tubular damage patients and the glomerular damage patients were higher than healthy group,and the result was statistically different(P <0.01);Compared with the glomerular damage patients,average relative added value in renal tubular damage patients was higher than that of glomerular damage,and the result was statistically different(P< 0.05).(2)Curative effect index1)By analyzing the data with two groups,the total effective rate of the treatment group was 96.67%,the total effective rate of the control group was 73.33%.there was statistical difference(P<0.05),Bushen Qutan Huayu Chinese herbal medicine group was obviously better than the only use of DMPS.2)Compared with pretherapy group,TCM syndrome value of two groups after treatment are lower,the difference with control group had no statistical significance(P>0.05),but the difference in treatment group had very significantly statistical mean(P<0.01);Compared post-treatment two groups,TCM syndrome integral value of the treatment group improved more significantly(P < 0.05).(3)Bushen Qutan Huayu prescription on Renal damage index1)Renal tubular damage index:Between two groups before treatment,U?2-MG ?U?1-MG?URBP?UNAG values had no statistical difference(P>0.05);Compared with the pretherapy group,U?2-MG?U?1-MG?URBP?UNAG values in the treatment group and control group after treatment came down,the difference in U?2-MG ?U?1-MG?URBP?UNAG values with treatment group was statistically significant(P<0.01),the difference in U?2-MG?U?1-MG?URBP values with control group was statistically significant(P<0.05);Compared post-treatment two groups,the bushen qutan huayu treatment group U?2-MG?U?1-MG?URBP?UNAG values improvement was more obvious,with U?2-MG?U?1-MG?UNAG values had significant statistical difference(P<0.05)and URBP value had no statistical significance(P>0.05).2)Glomerular damage index:Between two groups before treatment,serum Cys C,UIg G,UACR,UTRF values had no statistical difference(P>0.05);Compared with the pretherapy group,serum Cys C,UIg G,UACR,UTRF values in the treatment group after treatment came down,and the difference had statistical significance(P< 0.05),the difference in serum Cys C,UIg G,UACR values had very statistical significance(P<0.01);Serum Cys C,UIg G,UACR,UTRF values in the control group after treatment dropt,the difference with Serum Cys C,UIg G,UACR values existed statistical significance(P<0.05),the difference with UTRF value had no statistical significance(P>0.05);Compared post-treatment two groups,serum Cys C,UIg G,UACR,UTRF values in the treatment group were more significantly improved,and the difference in serum Cys C,UIg G,UACR values had statistical significance(P<0.05).(4)other Index1)Blood routine:Compared with before treatment,RBC,WBC,PLT values of the treatment group increased slightly,but the difference had no statistical significance(P>0.05);RBC,WBC,PLT values in the control group declined,but the difference had no statistical significance(P>0.05).Compared post-treatment two groups,RBC,WBC and PLT values of the treatment group were obviously higher than the control group,but the difference had no statistical significance(P>0.05).2)Liver and renal function:Compared with the pretherapy group,ALT,AST,Scr,BUN values of treatment group after treatment declined obviously,and difference in Scr,BUN values had statistical significance(P<0.05),the difference in ALT,AST values had very significantly statistical significance(P<0.01);ALT,AST,BUN,Scr values in control group dropt,the difference in ALT,AST values were statistically significant(P<0.05).Compared post-treatment two groups,ALT,AST,BUN,Scr values in treatment group dropt more obviously,the difference in ALT,AST,BUN,Scr values had significant statistical mean(P<0.05).(5)Side reaction:The bushen qutan huayu chinese medicine treatment group was10.00%,the control group was 46.67%,and the difference had statistical significance(P< 0.05).Conclusion:(1)There exists a certain degree of early kidney damage in Wilson disease patients;(2)There shows a positive linear relationship between age and Serum Cys C index;.(3)Renal tubules with Wilson disease patients are more sensitive to copper,and that are more likely to damage;(4)Combined early glomerular and renal tubular index can be more sensitive,more accurate,more safe to comprehensively evaluate early renal damage;(5)Bushen Qutan Huayu can better improve clinical symptom with Wilson disease phlegm-stasis and deficiency of kidney-essence patients,existing a certain degree of kidney preservation effect.