The Evaluation Of Diabetic Nephropathy Clinical Pathways Of Integrated Traditional Chinese And Western Medicine

BackgroundDiabetic nephropathy (DN) is the most serious of the most common diabetic microvascular complication of diabetes, and it is one of the main deaths. It was reported that DN in type 1 diabetes incidence rate is about 40% to 50%, and in type 2 diabetes is about 20%. Diabetic nephropathy is an end-stage renal disease (ESRD) in the most important reason. Chinese current diabetes over 50 million,93% of diabetes is type 2 diabetes patients, of whom 40% will develop to diabetic nephropathy. With the improvement of people's awareness of diabetes and clinical detection means perfect, in fact, the prevalence of diabetic nephropathy is much higher than this figure. In the United States and Europe, due to diabetic nephropathy has led to chronic renal failure and required dialysis or renal transplant patients, accounting for dialysis and renal transplantation 1/3. According to preliminary statistics of 1999, diabetic nephropathy in dialysis for the second cause, the cause of peritoneal dialysis in the third place, and estimated in the next 20 years will be the end-stage diabetic nephropathy the most important reason. Therefore, the prevention of diabetic nephropathy is the face of major health issues.Clinical pathway (CP) is a standardized method of treatment to shorten the average length of stay, medical expenses reasonably incurred characterized by disease to design the best treatment and care programs, according to the condition a reasonable time and cost of hospitalization arrangements. Clinical pathway has been confirmed that not only can effectively reduce the length of hospital stay and hospital costs, but also can significantly improve the quality of medical services by the national medical attention, since the 20th century, a new medical model.In this study the efficacy of clinical pathways to retrospective analysis, in order to further improve diabetic nephropathy Integrative Medicine clinical pathways provide an objective basis.Object ivesTo evaluation of diabetic nephropathy clinical pathways of integrated traditional chinese and western medicine.MethodsThe study select the patients whom the first diagnosed as "diabetic nephropathy" be in hospitalized in Endocrinology of Guangdong Provincial Hospital of TCM in 2008 as old-clinical pathway group, and the patients whom the first diagnosed as "diabetic nephropathy" be in hospitalized in Endocrinology of Guangdong Provincial Hospital of TCM in 2010 as new-clinical pathway group, compared with two groups of hospitalized patients with major relevant circumstances. The main evaluation indicators:such as length of stay, hospital costs, TCM symptom scores and so on.ResultThe study collects 114 cases in line with the inclusion criteria, including the new-clinical pathway group of 60 cases, and the old-clinical group of 54 cases. The total length of stay from 18.3±11.6 days down to 14.2±6.1 days (P<0.05), the total hospitalization cost was not increased by the new-clinical pathway group. The TCM symptom scores of new-clinical pathway group were less than the old one.ConclusionThe new-diabetic nephropathy clinical pathways of integrated traditional chinese and western medicine can safely reduce the TCM symptom scores and the total length of hospitalization stay. However, the total hospitalization cost is not increased.