| Chronic renal failure develops from course of chronic kidney disease.The systemic toxic symptoms is the manifestation of CRF. It caused by water-electrolyte and Acid-Base Balance, metabolite and toxin retention, and endocrine dyscrasia.The etiology of chronic renal failure is complicated, involving various primary and secondary factors.Due to the strong compensatory function of the kidney, even in the early and middle stage of chronic renal failure, the water and toxins in the body can still be largely removed in order to maintain the relative stability of the body.Therefore, patients with early chronic renal failure may have no special clinical symptoms.Chronic renal failure course in general is a progressive and irreversible development, eventually enter end-stage renal failure (ESRD). The serious decline in glomerular filtration rate (eGFR) leads to the failure of the body to maintain a stable internal environment, and only rely on hemodialysis, peritoneal dialysis or kidney transplantation to sustain life.At present, chronic renal failure has brought a heavy burden of care and a series of social problems to our society and people.Early prevention and treatment of chronic diseases such as CKD is conducive to improving the quality and health of the people, so the treatment of CKD, especially the focus of chronic renal failure should be in the early and middle.At present, the advantage of clinical medicine lies in the renal replacement therapy, and the Chinese medicine in the treatment of early and middle stage chronic renal failure clinical play a unique advantage.How to verify the unique efficacy of traditional Chinese medicine in the treatment of chronic renal failure, to further explore the name old doctor of traditional Chinese medicine treatment according to syndrome differentiation of chronic renal failure (CRF) features of treatment, prescription drug laws, mechanisms of action and target. This is our historical mission.I became the fifth batch of heir to the academic experience in August 2012, and learn from the old TCM professor Zou Yanqin.After 3 years of clinical practice and learning with the teacher, I can master the basic inheritance of Professor Zou Yanqin’s academic thought and clinical experience and technical expertise, and innovation..In this study, the TCM treatment of diseases have obvious advantages such as chronic renal failure is introduced into the clinical path, and by clinical pathway method, the country’s name old doctor of traditional Chinese medicine academic experience is integrated into the clinical pathway treatment programs. The more prominent traditional Chinese medicine in the treatment of chronic disease characteristics and advantages.Under the premise of TCM syndrome differentiation and treatment superiority and definite curative effect, clinical pathway makes the diagnosis and treatment of chronic renal failure to achieve standardization, standardization and procedures, is conducive to the scientific and systematic summary of the old Chinese medicine experience and inheritance, development and innovation.Professor Zou is the fourth generation of the famous doctor Fei Boxiong who belongs to Meng He Yi Pai. She is also the daughter of the famous Chinese medicine experts Zou Yunxiang Professor. She is the Ministry of health of the national name of the old Chinese medicine academic experience inheritance work third, second, fourth, the fifth batch of guiding teacher, the State Administration of traditional Chinese medicine and traditional Chinese medicine clinical research talents first, third, second groups teacher, the first Master-apprentice system postdoctor’s teacher, the expert of he national famous Chinese medicine Zou Yanqin studio.Now she becomea a leader of renal disease treatment center for traditional Chinese Medicine in Jiangsu Province Hospital of TCM and key subjects of the State Administration of traditional Chinese Medicine. She served as the second director of the National Institute of traditional Chinese Medicine and Jiangsu branch, vice chairman of the second session of the National Committee of Chinese Medicine, member of the fourth national Chinese Medicine Review Committee of the state fifth, the National Natural Science Foundation of China, the first member of the professional committee of Chinese Medicine in Jiangsu(present adviser).She is the Jiangsu provincial government named the "Jiangsu Province Traditional Chinese doctor", expert with State Department special allowance.Theoretical research Professor Zou’s academic thought originate from the Meng He Yi Pai, inheriting learning experience of Professor Zou Yunxaing.Professor Zou Yunxiang pay attention to the maintenance of kidney qi, running of blood and qi, treatment according to syndrome differentiation, The overall adjustment, this makes deep impact of Professor Zou’s Treatment rules.Meng He Yi Pai’s academic ideas come from Classics on TCM including Su Wen, Miraculous Pivot, Treatise on Febrile Diseases, Synopsis of Golden Chamber, and so on. Its academic thinking is mainly manifested as a "gentle, plain, mellow". In medical discourse is not biased on alcohol, in the prescription is partial to slow, dull and drastic.Professor Zou’s academic thought can be summarized as Kidney maintenance, both the the five internal organs, Yin-Yang Balancing, pay attention to spleen and kidney, distinguish the actual situation, weigh specimens priorities, treat gentle, drug reuse, variform route of administration.Through the treatment of chronic renal failure, Professor Zou Yanqin inheritance and innovation of the Meng He academic thought. She thinks consumptive and internal miscellaneous diseases caused by Qi and blood, tonifying the spleen and the kidney,she raises that tonifying kidney must tonifying spleen at the same time.Professor Zou inherited the thought that tonifying spleen and kidney is very important,also protecting Stomach-Qi,the spleen and stomach is filled with the innate kidney,she raises that tonifying kidney must tonifying spleen at the same time,against the use of injury stomach medicine abortion. Strengthening the body resistance to eliminate pathogenic factors and treat gentle.Professor Zou make Fei Boxiong’s point of view,and used in clinic. She also paid great attention to the nutritional therapy with Chinese Medicative Diet. The treatment of the disease cannot be treated with drugs alone, also the diet.Inheritance and innovation of Professor Zou Yanqin:application software for diagnosis and treatment of acute and chronic nephritis,application software of diagnosis and treatment of renal diseases. She thinks stagnation of blood and qi, poor circulation,and renal collateral obstruction results in nephropathy. Blood-promoting improves therapeutic effect,especially on chronic kidney disease. Professor Zou Yanqin further innovative rhubarb treatment of uremia On the basis of her father’s theory.Rhubarb has a variety of uses In clinic,commonly used oral and enema.Oral is based on syndrome differentiation combined with different dose of rhubarb, enema with the basic fixed enema. Nephropathy pathogenesis is complex and changeable, the actual situation and, ColdHeat complex, especially to the development of end-stage, there is more false, and evil more Sheng climate, so the clinical shall not specializing in tonic nor specializes in attack.This complex disease requires a combination of drug therapy,considering primary and secondary,With differentiation of disease.Professor Zou often tell us that not drug Sibu, medication than diet.Syndrome differentiation and treatment and diet tyerapy can use together.Recognition on CRF,Professor Zou classified CRF as consumptive disease.Failure of kidney causes CRF,retention of dampness is main manifestation.It belongs to asthenia in origin and asthenia in superficiality caused by excess caused by deficiency.The location is related to liver, spleen and kidney.Qi deficiency of spleen and kidney and internal retention of Gore and Phlegm is the most common syndrome in early and mid-term CRF.Treatment of Spleen, tonifying the Kidney and Invigorating Qi and blood-promoting used commonly,and has better curative effect.Professor Zou Yanqin believes that the provisional certificate should focus on differentiation, but also to identify disease. "The protection of kidney qi, yin and Yang" is an important principle of treatment in the treatment of chronic renal failure.Professor Zou Yanqin further studied the clinical preparation, pharmacological action and action mechanism of the kidney preservation pill, Bao Shen pill. She put the kidney a pill, kidney B pill concentrated agent changed its name to protect kidney slices, in 2010 the new drug named Shen Wu Yi kidney film, in 2010 to get the national new drug certificate (national drug Z20100051) and the national key new product certificate.In the long-term clinical treatment, professor Zou Yanqin is processing the relationship between syndrome type of traditional Chinese medicine, therapy, medication, embodies the basic principle of "party from the method, with the card". This is the complete inheritance of traditional Chinese medicine theory, and often have innovation.Rlinical research Objective:To explore the rule of syndrome differentiation in the early and middle stage of chronic renal failure by Professor Zou Yanqin, to promote effective and repeated prescriptions, and to establish a clinical pathway for the treatment of chronic renal failure in early and middle stage(Qi deficiency of spleen and kidney, internal retention of Gore and Phlegm).Object and method:Case selection, diagnosis, syndrome differentiation and therapeutic effect determination are based on the guiding principles of clinical research on new drugs of traditional Chinese medicine. The treatment group were treated with traditional Chinese medicine decoction of tonifying kidney and spleen qi, promoting blood circulation and removing turbidity.The control group was given haikunshenxi capsule.Using the software SPSS 20.0 the data were analyzed statistically and quantitative data with mean+standard deviation(x+s), between the groups compared using independent samples t test, qualitative data compared using chi square test, P< 0.05 was statistically significant.Results:The treatment group of 30 cases, there were 20 males and 10 females; aged 34～81 years old, average 52.63+14.13; duration 1～120 months, average 42.07+6.26.The control group of 30 cases, including 12 males and 18 females, aged from 25 to 80 years old, with an average of 54.67+17.02; the duration of 3-100 months, with an average of 37.97+5.32.There was no difference in gender, age, course of disease and renal function between the two groups.In clinical efficacy, the treatment group was effective in 2 cases, stable in 24 cases, ineffective in 4 cases, the total effective rate was 86.7%.In the control group, the total effective rate was 53.3%, and the two groups had significant difference (P< 0.05).The treatment group of patients after treatment of TCM syndrome score were significantly decreased (P< 0.05).After treatment, two groups of serum creatinine values were compared by statistical P= 0.001 (P< 0.05), urea nitrogen values were compared by statistical P= 0.01 (P< 0.05), glomerular filtration rate (eGFR) compared with statistical P= 0.0001 (P< 0.05).Conclusions:The treatment of chronic renal failure in early and middle stage has definite clinical curative effect, significantly improve the clinical symptoms of chronic renal failure patients, improve the quality of life of patients with chronic renal failure.In chronic renal failure patients, the levels of serum creatinine and urea nitrogen were significantly decreased, and the glomerular filtration rate (eGFR) in patients with chronic renal failure could be improved.Anemia in patients with chronic renal failure is not worse, it is safe and effective.Clinical pathway of chronic renal failure in traditional Chinese Medicine Clinical effect of early and middle stage (Qi deficiency of spleen and kidney, internal retention of Gore and Phlegm) of chronic renal failure is based on kidney spleen qi and promoting blood circulation and eliminating turbid therapy of Professor Zou Yanqin.To develop the clinical pathway of Professor Zou Yanqin in the treatment of chronic renal failure with early and middle stage (Qi deficiency of spleen and kidney, internal retention of Gore and Phlegm) experience, and to verify the clinical observation. |
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