| Objective:Observation of urinary microalbumin-creatinine ratio(ACR)and 24 h urine protein quantification(24h Upro)by observing the treatment of patients with diabetic nephropathy stage Ⅲ-IV(qi and yin deficiency and blood stasis syndrome)combined with Yiqi Yangyin Huoxue Decoction and Losartan Potassium Tablet),blood creatinine(Scr),blood urea nitrogen(BUN),glomerular filtration rate(GFR),fasting blood glucose(FPG),glycosylated hemoglobin(Hb A1c)and the influence of TCM syndrome integral,to explore the effects of nourishing qi,nourishing yin and promoting blood circulation The clinical efficacy and safety of the prescription combined with Losartan potassium tablets in the treatment of stage Ⅲ-IV diabetic nephropathy(the syndrome of deficiency of both qi and yin and blood stasis).Methods:A total of 96 patients with diabetic nephropathy who met the enrollment criteria in the Endocrinology Department of Shanxi Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into the treatment group and the control group with 48 cases in each group using the statistical random number table method.Both groups were given diabetic nephropathy.For treatment(diet,exercise,lowering blood sugar,lowering blood pressure,lowering lipid),on this basis,losartan potassium tablets were taken as the control group,and the treatment group was taken orally on the basis of the control group with Yiqi Yangyin Huoxue Decoction.The levels of ACR,24 h Upro,Scr,BUN,GFR,FPG,and Hb Alc were observed before and 12 weeks after the treatment,and the treatment effect was evaluated by observing the patients’ TCM syndrome scores.Results:(1)Comparison of the total effective rate between the two groups: After 12 weeks of treatment,the treatment group showed clinically effective 9 cases,effective 34 cases,and ineffective 5 cases,the total effective rate reached 89.58%;the control group clinically effective 5 cases,effective 28 cases,and ineffective 15 cases,total The effective rate is68.75%.After Chi-square test,the difference was statistically significant(P<0.05).(2)Comparison of the efficacy of TCM syndromes: the total scores of TCM syndromes and muddy urine,fatigue,shortness of breath,dry mouth,dry mouth,frequent urination,hot hands and feet,numbness or tingling of limbs,wrong skin,complexion The symptoms of Mucuna pruriens or dullness were significantly lower than before treatment,and the difference was statistically significant(P<0.05);after treatment,the total score of TCM syndromes and turbid urine,fatigue,shortness of breath,and dry throat were compared between the treatment groups.The symptoms of dry mouth,frequent urination,numbness or tingling of limbs,dark complexion or dull complexion were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the two groups of patients had no significant difference in symptoms of hand,foot,heart,and skin nails,P>0.05.(3)The laboratory indicators of the two groups were analyzed one by one,After treatment,the values of ACR,24h-Upro,Scr,BUN,FPG,and Hb Alc of patients all decreased,and the value of GFR increased,and the difference was statistically significant compared with that before treatment(P<0.05));And the comparison between the groups after treatment,the treatment group was significantly better than the control group in terms of improving ACR,24h-Upro,Scr,BUN,and GFR(P<0.05).After treatment,there was no significant difference between FPG and Hb Alc between the two groups(P>0.05).(4)Comparison of safety indicators between the two groups: there were no abnormal changes in the two groups before and after routine treatment of alanine aminotransferase(ALT),blood,and stool.Conclusion:(1)Yiqi Yangyin Huoxue Decoction combined with Losartan Potassium Tablets has obvious curative effect in the treatment of diabetic nephropathy stage Ⅲ-Ⅳ(qi and yin deficiency and blood stasis syndrome),which can significantly reduce proteinuria,improve renal function indexes,and increase glomerular filtration rate,Reduce the efficacy scores of traditional Chinese medicine syndromes,effectively improve the symptoms of muddy urine,fatigue,shortness of breath,dry throat,dry mouth,frequent urination,numbness or tingling of limbs,dark complexion or dull complexion,thereby protecting kidney function and delaying The possibility of decreased renal function.(2)After treatment,the two groups of patients had no significant changes in ALT,blood routine,stool routine and other indicators,indicating that the clinical application of Yiqi Yangyin Huoxue Decoction combined with Losartan potassium tablets in the treatment of diabetic nephropathy is safe and has no toxic side effects. |
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