Joint Tripterygium Wilfordii Glycoside More Chinese Medicine Treatment Of Diabetic Nephropathy Ⅳ Period Of Clinical Observation

Objective:To observe and summarize the therapeutic effect of formula granule QITENGDIHUANG Granule combined with Tripterygium wilfordii(TW) on proteinuria in patients suffered from diabetic nephropathy(DN) Ⅳ with deficiency of both qi and yin of syndrome differentiation in traditional Chinese medicine, by comparing changes in symptoms scores and laboratory index before and after treatment.Method:40patients diagnosed with DN IV with deficiency of both qi and yin of syndrome differentiation was recruited from5hospitals and randomly assigned to both formula granule QITENGDIHUANG Granule and TW(Combination group), QITENGDIHUANG Granule(Chinese herb medicine group),and valsartan(Western medicine control group) for one month.All groups received dietary guidance and hypoglycemic and stating therapy. Urine protein、albumin、eGFR、renal function、liver function、electrolyte、complete blood count、 serum lipid. blood glucose was tested at the begining and after the treatment,and clinical symptoms were scored at the same time.Reaults:The symptom integral significantly decreased in all three groups (P<0.01) after one months of treatment,although there is no statistical difference between groups (P>0.05) as well as in the total curative effect. BMI、waist hip ratio and perimeter of shanks. Chinese herb medicine group had improvement in society domain of WHOQOL-BREF after treatment.24h urine protein quantitation reduced in Combination group,and there was a significant difference in the decrement of24h UPQ after treatment compared with Chinese herb medicine group and Western medicine control group. There was a downtrend of SCr in Combination group,when it showed a uptrend in Western medicine control group.Concerning the change in eGFR,there was also a downtrend in Western medicine control group when there was no marked change in Combination group and Chinese herb medicine group.There was no significant difference in the decrement of BUN.2hPG decreased in Chinese herb medicine group,when there was no marked variation in Combination group and Chinese herb medicine group.There was no significant difference between groups in electrolyte and CO2CP.TG reduced significantly in Chinese herb medicine group and Western medicine control group(P<0.05),while there was a downtrend of TC in all of them and no significant difference between groups.There was no significant change in blood pressure, heart rate, respiratory rate during the trial.Compared with Chinese herb medicine group,ALT showed a significant increase in Western medicine control group(P<0.05),but there was no significant difference in increment of ALT and AST between groups.Conclusions:The combined therapy of QITENGDIHUANG Granule and Tripterygium wilfordii can reduce the24h urine protein quantitation in patients of DNⅣ with deficiency of both qi and yin effectively, maintain renal glomerular filtration rate and show a potential effect of decreasing SCr and protect renal function as results.With regard to symptoms,the combined therapy can improve thirst and dizziness,while using QITENGDIHUANG Granule alone showed a significant improvement in soreness of waist and limbs flaccid、lassitude and foam in urine.This study also found that the combined therapy was safe to the most of patients of DNIV.