Clinical Study On The Relationship Between Laboratory Index And Traditional Chinese Medicine Type Of Diabetic Nephropathy Syndrome

Objective:This paper mainly discusses the intrinsic link between the differentiation for syndrome classification of diabetes nephropathy (DN) and the clinical objective of Insulin Sensitive Index,24-hour urine protein, Cysc, CRP,β2-MG, Lipids, which provides a reference for DN and theoretical basis and clinical arguments for the combination treatment of DN by TCM and Western Medicine.Methods:This paper selects120patients which diagnosed with DN by the department of Endocrinology of the First Hospital of Wuhan from November of2010to November of2011.62cases of male and58cases of female, which aged37-80are averaged61.79+10.74years. The selected patients fit for the diagnostic criteria of DN which developed by renal branch of the Chinese Medical Association. Referring to the Chinese Medical Association in2007renal branch’s "diagnosis of diabetic nephropathy, syndrome type and efficacy evaluation standards" for TCM type, it can be divided into Yin hot type, and Yin Deficiency type, spleen and kidney Qi virtual type and the yin and yang Deficiency type. Among them there are22cases of Yin hot type,41cases of Yin Deficiency type,27cases of spleen and kidney Qi virtual type and Yin and Yang Deficiency type, which all after a detailed talking about the disease history and systematically physical examination and Laboratory examination of relevant indicators. This paper chooses30cases healthy subjects in our hospital as normal controls, compared with the group of patients with DN respectively by measuring height, weight,24-hour urine protein, FPG, FINS, Lipid, Cysc, CRP,β2-MG and other related laboratory tests. All the measurement data with X±S (mean±standard deviations) that would use the test, X2test with count data and observations were statistically analyzed by using SPSS17.0.Results:1. DN group of syndromes of insulin sensitivity index (ISI) were lower than the healthy control group (P<0.01). And insulin sensitivity index was gradually increased by Yin hot group, Qi Group, spleen and kidney qi virtual group, yin and yang group respectively; the insulin sensitivity index increases with the disease gradually increased, which are significantly different in each group pair wise comparisons (P<0.01).2. Compared with the healthy control group, the patients with DN group’s TG, TC, LDL levels were significantly increased (P<0.01), DN of the group of syndromes was gradually increased according to Yin hot group, Qi Group, spleen and kidney Qi virtual group and Yin and Yang group while HDL levels were significantly decreased (P <0.01) and the DN groups of syndromes would reduced according to Yin hot group, Qi Group, spleen and kidney Qi virtual group and Yin and Yang group.3. Comparing with the healthy control group, DN group was significantly increased on the levels of24h urine protein, Cysc, CRP and β2-MG; DN group of syndromes would be higher with the change of24h urine protein, Cysc, CRP, P2-MG Yin hot group, Qi group, spleen and kidney qi virtual group, yin and yang group, that is to say changing with the duration of the extension and exacerbations.4. Patients with DN compared with the incidence of other complications, DN patients with diabetic retinopathy was significantly higher incidence (P<0.01).Conclusion:1. Hyperlipidemia play an important role in the development process of diabetic nephropathy.24-hour urine protein and Cysc, CRP, β2-MG response to disease progression of diabetic nephropathy.2. Various syndromes of diabetic nephropathy in TCM reflect the different stages of pathological change and provide a clinical basis for the treatment of diabetic nephropathy. The study on Qi Deficiency is the most common description of Qi and Yin, which illustrates the Qi and Yin Deficiency, is the basic diabetic nephropathy syndrome and the development of the DN syndrome. Deficiency of yin and yang of the clinical indicators is of more serious than the other syndromes, which reflect the yin and yang, is the terminal syndrome of DN. 3. Compared with the healthy control group, there exists the reducing of different degrees of insulin sensitivity of DN of the syndrome group (P<0.01); ISI degrees varying with the different syndromes, suggesting that ISI can be severed as a reference of diabetes medicine.4. Since with high incidence of diabetic retinopathy of DN patients, suggesting whether merger the diabetic retinopathy or not as one of a reference of the DN and other kidney diseases in the differential diagnosis.