Clinical Observation Of Yiqi Huoxue Decoction In The Treatment Of Spleen And Kidney Qi Deficiency With Blood Stasis Type In Chronic Kidney Disease(CKD3-4stage)

ObjectiveTo inherit and carry forward academic ideas of postgraduate tutor,which is “benefite qi and enhance immunity,improve blood circulation and dredge the collaterals”.Observing the influence of yiqi huoxue decoction in the treatment of spleen and kidney qi deficiency and blood stasis syndrome in stage 3-4 of chronic kidney disease before and after treatment,including traditional chinese medicine symptoms and laboratory indexes.To evaluate its clinical efficacy and safety.MethodsAccording to the principle of controlled trials,dividing the patients that in line with CKD3-4 of spleen and kidney qi deficiency with blood stasis type into experimental group and control group randomly.The control group was given basic treatment,and the treatment group received all the same treatments as the control group,except for taking yiqi huoxue decoction,with a course of 12-weeks.The changes of serum creatinine,urea nitrogen,uric acid,cystatin C,glomerular filtration rate,24-hour urine protein quantification,TCM syndrome score,and safety indexes were observed before and after treatment.Statistical analysis of the data was then performed.Results1.Comparison of baseline:Sixty-five qualified cases were participated in this subject study.Experimental group and control group had no statistical difference in the gender,age,course of a disease,laboratory indicators,and TCM symptoms,stage of CKD(P﹥0.05).2.Comparison in total effective rate :Comparing total effective rate before and after treatment of two groups,84.4% in the experimental group and 69.7% in the control group,P=0.043<0.05,it has statistical significance between two groups(P<0.05).3.Comparison of TCM symptoms:Experimental group and control group were alleviated TCM syndromes such as fatigue,anorexia,shortness of breath and laziness,weakness of waist and knees,bloat and etc belonged to pleen and kidney qi deficiency syndrome;rough and dry skin,limb numbness,darkness of face color,lumbago,etc belonged to blood stasis syndrome.The effective rates were 84.38% and 60.60% respectively.Compared two groups was statistically significant(P=0.010<0.05).4.Comparison of statistical analysis results: After statistical analysis,comparison results after treatment indicated that both two groups were statistically significant in reducing SCR,UA,Cys-C,decreasing 24 h UPRO and increasing GFR(P﹤0.05),and the experimental group was better than control group.Comparison between groups showed that the experimental group had statistical significance in reducing FIB,D-Dimer(P﹤0.05).The control group had no statistical significance in reducing FIB,D-Dimer(P>0.05).5.Comparison of safety indicators:Before and after the study,there were no statistical significance in routine blood test(HGB、RBC、WBC、PLT),electrolytes(K、Ca、P、CO2CP),liver function(ALT、AST)between the experimental group and control group(P﹥0.05).Conclusion1.The treatment of spleen and kidney qi deficiency and blood stasis type in stage 3-4of chronic kidney disease with yiqi huoxue decoction combined with western medicine alleviated the TCM syndromes like fatigue,shortness of breath,loose stools and etc that belonged to pleen and kidney qi deficiency syndrome;darkness of face color,lumbago,dry skin with scales,and etc that belonged to blood stasis syndrome.2.The treatment group was remarkable better than the control group that simply used western medicine basic treatment in improving kidney function(SCR、UA、BUN、Cys-C),reducing 24 h UPRO、GFR,in improving FIB、D-Dimer.