Clinical Study Of Shenluoyubi Symptoms In Chronic Glomerulonephritis (CKD3) Patients

Objective:To investigate Traditional Chinese Medical (TCM) characteristics, clinical pathological manifestation of ShenLuoYuBi (YuBi) symptoms in chronic glomerulonephritis (CKD3) patients and effects of jixuecao compounds, benazapril, combined with benazapril and jixuecao compounds.Methods:A multicenter double blind double dummy randomized controlled clinical study was applied. The patients who were Chronic glomerulonephritis (CKD3stage) had ShenLuoYuBi symptoms with ShenQiYinXu(ShenXu),FengShiNeiRao(FengShi) and ShiReNeiYun(ShiRe) symptoms respectively by syndromes differentiation. The correlations among occurrence rate of ShenLuoYuBi symptom, TCM characteristics, proteinuria, renal function and renal pathological manifestation were analyzed. The147patients were divided into benazapril (48patients), jixuecao compounds (50patients),combined with benazapril and jixuecao compounds groups (49patients). The SPSS17.0was applied.Results:Occurrence rate of ShenLuoYuBi symptoms in chronic glomerulonephritis (CKD3) patients was69%, accompanied with ShenXu, FengShi and ShiRe symptoms. The patients with two manifestations(YuBi and ShenXu symptoms) had higher scores of YuBi symptoms and squamous and dry skin than the patients with three manifestations (YuBi,ShenXu and FengShi symptoms)(p<0.05). The scores of YuBi symptoms were correlated with UPro/24h. The scores of hematuria which was different from other symptoms of YuBi were also correlated with UPro/24h (p<0.01). According to Andreoli's scores, the patients in CKD3stage both had acute and chronic pathological injury of nephrology, and the scores of chronic pathological injury were higher than the acute injury. Among the acute pathological injury, the number of cellular crescent was greater than others. The scores of segment of glomerular sclerosis were highest in chronic pathological injury. TCM symptom markers in three groups were decreased after treatment (p<0.01). The scores of hematuria had been improved by combined with benazapril and jixuecao compounds treatment while jixuecao compounds or benazapril respectively had no effects (p<0.05). Proteinuria in the patients were increased significantly after treated with jixuecao compounds while e-GFR was raised (p<0.05). The UPro/24h of patients which treated with benazapril reduced effectively than the patients of jixuecao compounds (p<0.01).Proteinuria in the patients treated with benazapril and jixuecao compounds had decreased and renal function had been improved (p<0.05), and the results showed better effect than jixuecao compounds and benazapril treatment respectively.Conclusion:ShenLuoYuBi symptoms in chronic glomerulonephritis (CKD3) patients are common and accompanied with other TCM symptoms. Hematuria was correlated closely with CKD and would be useful in dialectics of YuBi symptoms in the future. Traditional medicine show renal protective effect independence of lowering proteinuria and improve anemia. Combined with benazapril and traditional medicine show lowering proteinuria and renal protective effect in CKD3patients.