Application Evaluation Of Traditional Chinese Medicine Clinical Path Of Diabetic Nephropathy (Liver Kidney Yin Deficiency And Phlegm And Blood Stasis Syndrome)

Objective: Based on Diabetic nephropathy(DN)TCM optimized treatment plan,the DN TCM clinical pathway(CP)was constructed and optimized,and the path was used to clinically treat patients with DN(liver kidney yin deficiency and phlegm and blood stasis syndrome)in the early and middle stages.Observe and evaluate the application effect,and provide reference for further optimization and promotion of DN Chinese medicine CP.Methods: 70 patients with DN who met the inclusion criteria From January 2018 to January 2019,in our Department of Endocrinology and Metabolism,Changchun University of Traditional Chinese Medicine,were randomly divided into the routine control group and the optimized path treatment group.And in the literature comparison method,35 cases of the literature control group that met the inclusion criteria and applied the routine experience program in the past 5 years were compared and compared.Observed the clinical efficacy and test indicators(urine microalbumin,24 h urine protein quantitation,urinary microalbuminuria/urinary creatinine,fasting blood glucose,glycated serum protein),length of hospital stay,hospitalization expenses,and patients in the routine path control group and the optimized path treatment group.Changes in patient satisfaction,quality of life scales,etc.before and after hospitalization,and clinical efficacy and test indicators after statistics from the literature control group(urine microalbumin,24 h urine protein quantitation,urinary microalbuminuria/urinary creatinine,fasting blood glucose,Glycosylated serum protein),hospitalization days,hospitalization costs were compared.All data were statistically analyzed using SPSS 23.0.Results: There was no significant difference in the general data of patients(P>0.05).The total effective rate was 91.42% in the optimized path treatment group,88.57% in the conventional route control group,and 82.85% in the literature control group.The overall effective rate of the three groups was statistically significant(P<0.05).In the optimized path treatment group,the glucose metabolism,urinary albumin,urinary albumin/creatinine,24-hour urine protein quantitative improvement were better than the conventional pathcontrol group(P<0.05),and the difference was statistically significant.There was a statistically significant difference in the corresponding index of the literature control group(P<0.05).In terms of economic evaluation,the average length of hospital stay in the optimized path treatment group was 12.62±2.81 days,the average total cost was 10463.79±3919.84 yuan,and the average western medicine cost was 2804.35±1683.92 yuan,which was lower than the conventional path control group(15.02±3.60 days,12577.11±3526.63).Yuan,4432.21±2275.58 yuan)and literature control group(17.14±2.66 days,16273.80±3034.51 yuan,6250.59 ± 2247.80 yuan),the difference between the three groups was statistically significant(P<0.05).In the satisfaction survey,the satisfactory rate of treatment in the optimized path treatment group was 94.28% higher than that in the conventional path control group(P<0.05).During the test,there were no abnormalities in the safety indicators.Conclusion: The application of DN(liver kidney yin deficiency and phlegm and blood stasis syndrome)has a more significant therapeutic effect,which shortens the hospitalization days of patients to a certain extent,reduces the total hospitalization expenses and western medicine costs,and the Chinese medicine costs are not reduced but the patient satisfaction is lower.High,reflecting the characteristics of Chinese medicine treatment of DN,but still need further improvement,verification and promotion.