Clinical Study On The Treatment Of Ⅳ Stage Of Diabetic Nephropathy By Tonifying Deficiency And Cultivating Archaeus,Detoxification And Dredging Collaterals

Objective: To verify the efficacy and safety of the therapy,tonifying deficiency and cultivating archaeus,detoxification and dredging collaterals,to the patients with Ⅳ stage of diabetic nephropathy,we observed some indicators,including the changes of traditional Chinese medicine(TCM)syndrome scores,24-hour urinary protein quantity(24h-Upro),serum albumin(ALB),fasting blood glucose(FPG),2h blood glucose after breakfast(2h PG)and serum creatinine(Scr).The course of treatment was 3 months.Methods:On the basis of inclusion criteria and exclusion criteria,the 72 patients were randomly divided into treatment group and control group,each group had 36 patients.Each group was treated with low salt,low fat,high quality and low protein diabetic nephropathy diet,hypoglycemic drugs or insulin therapy,statins,irbesartan capsule and compound α-ketoacid tablets.The control group was treated with basic treatment,and the treatment group was treated with self-made prescription of tonifying deficiency and cultivating archaeus,detoxification and dredging collaterals,basing on the control group.The medication period is 3 months.Using the method of overall comparison of different groups,the changes of TCM syndrome scores in 2 groups,24h-Upro,ALB,FPG,2h PG and Scr were compared.Results:Based on the current sample size,as far as the overall effective rate of western medicine is concerned,the treat-ment group is 93.94% and the control group is62.86%,which was obvious as can be seen(P<0.01).The treatment group was significantly better than the control group(P<0.01)in improving 24h-Upro.Both groups had significant effects(P<0.01)in reducing FPG,but the effect of treatment group was better than that of control group(P<0.01).In the aspect of reducing 2h PG,the effects of the two groups after treatment were significant(P<0.01),but the effect of the treatment group was better(P<0.01).Compared with the control group,the treatment group had an excellent effect on Scr reduction(P<0.05).As for the improve-ment of ALB,the effects of2 groups were not significantly different(P>0.05).And overall effectiveness of TCM was obviously better than that of control group(P<0.01).When com-pared with the control group,the treatment group had obvious effect on improving TCM syndrome scores(P<0.01).In terms of improving the single syndromes of TCM,both groups had lower scores of individual syndromes,which had significant effects on the indexes of fatigue,lack of qi,self-sweating,edema,dry pharynx thirst,hot hand and foot,fat tongue and fine veins(P<0.01).And the treatment group was better than the control group in improving dry pharynx thirst,fat tongue and fine veins(P<0.05).There was no apparent adverse reaction in the 2 groups,also there was no apparent abnormality in every safety index.Conclusion: The clinical symptoms and some correlative tests indexes of patients who suffered from Ⅳ stage of diabetic nephropathy(Syndrome of Qi-yin deficiency,toxin and blood stasis in kidney collaterals)were satisfactory,the curative effect and safety were good.It is worthy of clinical application.