Clinical Study Of The Effects Of Modified Qihuang Yin On Early DN And CysC

Background:Diabetic nephropathy is one of the complications of the most common chronic diabetic microangiopathy, and is the main cause of end stage renal disease (ESRD), which determines the prognosis of the diabetes. As the incidence rate of the diabetes is increasing year by year and the population quota in our country is large, the prevention work is in the challenge, and the defects of western medicine in treating this disease promote the new therapeutic methods of treating the diabetes to be a common consensus. The study found that in treating diabetic nephropathy, Chinese medicine can not only against diabetes, but also can decrease proteinuria, improve renal function and postpone the deterioration of disease. Owing to its little side effects and low price, the Chinese medicine can be easily accepted by the patients. By observing the clinical symptoms of modified Qihuang yin on the early DN, CysC and the rate of proteinuria excretion, this topic can be an effective basis for treating diabetic nephropathy by Chinese medicine and release the treatment pressure of diabetic nephropathy.Objective:This thesis is to clinically observe the clinical effects of modified Qihuang yin on the early DN, and to examine the biochemical criterion of CysC, then to provide effective basis for treating early DN to further analyze the influence and interaction mechanisms of Chinese Medicine on early DN.Methods:1. Simply and randomly divided the 60 patients that were in inclusive criteria into two groups, named Group A and Group B, each 30 cases. Group A (the team by routine therapy):referring to the A Guide on Preventing DN (a revision in 2007), Chinese Medical Association, the patients were given the diabetes education and low protein diet of high quality and diabetic diet (protein 0.6-0.8g/kg/d);and controlling the blood sugar:orally took glurenorm (gliquidone, Beijing Wanhui Shuanghe Pharmaceutical Industries Co., Ltd),30-180g each day, and 2 or 3 times a day, then took insulin if the controlling of blood sugar was not ideal. And orally took Fosinopril Sodium (China-USA Shanghai Shiguibao Pharmaceutical Industries Co., Ltd) 10mg each time and one time a day.Group B (intervention team by Chinese Medicine) is treated by the above basic treatment of western medicine plus Chinese Medicinal decoction (Qihuang yin), one dose each time and one time each day. The Composition and dosage form of the Chinese Medicinal recipe were as follows:Taizishen 15g, Huangqi 30g, Shengdihuang 25g, Shanzhuyu 10g, Shanyao 20g, Yunling 12g, Danpi 10g, Nvzhenzi 10g, Chantui 20g, Xihuangcao 20g, Baomaogen 15g, all provided by Guangdong Yifang Limited Company. Recorded the symptoms, physical signs and so on from the beginning to the second week, routinely assayed the blood, the urine and the stool, examined the function of liver and kidney, and then recorded the scores of Chinese Medicinal symptoms. And examine the changes of CysC, the rate of PRO, glycosylated hemoglobin, fasting glucose, creatinine urea nitrogen and the Alanine Aminotransferase (ALT) before and after the treatment.2. After the clinical observation, statistically analyzed the data by SPSS 13.0.Results:1. As a result of the statistic analysis, the general information of the two groups, including the genders, ages, points of the Chinese Medicinal symptoms before treatment and the patient acuity, all had no statistical meaning in between, and then can be compared.2. The symptoms were decreased in both groups after treatment, and both had statistical meaning (P<0.05).After treatment, the process improvement in Group B was better than in Group A, and the difference was significant (P<0.05). Moreover, divided the scores of Chinese Medicinal symptoms into two groups (one group≥70% and the other< 70%), the improvement and the therapeutic effect in Group B was better than in Group A.3. The difference of CysC, UAER, FBG, HbAlc before and after treatment was significant (P<0.05); and the CysC, UAER, FBG, HbAlc in the two groups both declined after treatment, and Group B was better than Group A, the difference was significant (P<0.05).4. The BUN, Scr, ALT had no difference before and after treatment and had no negative reactions or toxic and side-effects during the whole Experimental process.Conclusion:The modified Qihuang Yin can significantly improve the clinical symptoms of DN due to Qi-yin deficiency; decrease CysC, and reduce the damage of early DN glomerulus. It can also decrease the rate of DN proteinuria excretion, remiss the high filtration of early DN glomerulus, protect and recover the renal function, postpone the falloff of renal function, effectively stop the development of the early DN, and simultaneously and significantly lower the level of UAER, FBG, HbAlc in the blood and improve the glucose metabolism, lower the blood sugar, decrease the high filtration of glomerulus and remiss the changes of renal structure and function. Being a safe and effective decoction, the modified Qihuang Yin has no side effectives in treating early DN due to Qi-yin deficiency, and the therapeutic effect by Chinese medicine integrated with western medicine is better than simply treated by western medicine.