TCM Efficacy Standard Target Angelica Mixture Treatment Of Chronic Renal Failure

BackgroundChronic kidney disease (CKD)is a long-term threat to human health and life of common chronic diseases. It Has the characteristics of high morbidity, high mortality, high medical cost and not easy to be found, and the morbidity is increasing year by year. Modern medicine is no effective drugs can improve the condition of renal failure currently. The Traditional Chinese Medicine(TCM)have unique advantages and good Therapeutic effectiveness of treatment and prevention of Chronic Renal Failure(CRF). Based on traditional Chinese medicine priscriptions "Angelica blood tonic soup",and combining the characteristics of Kidney disease,made a combination of Chinese herbs, Astragalus membranacets var. mongholicus and Angelica sinensis(A&A). Number of Clinical studies and experimental study have initially confermed the validity of A&A used in the treatment of chronic kidney disease.ObjectiveThis study was a prospective controlled study in patients with chronic Kidey disease3to4stage, and observed the dynamic changes after A&A threatment of the indicators. To reveal the relative factors affecting curative effect in treatment for chronic kidney disease of A&A and TCM syndromes of target. To explore the best course of A&A treatment of chronic kidney disease.MethodsForty three cases of CRF(CKD2-4) patients who were met the inclusion criteria were selected in this prospective study. On the basis of therapy plus taking A&A. The patients were divided into three different treatment groups were observed period was3months,6months,12months. After stopping for some patients continue to observe three months. The therapeutic effects were compared the before and after treatment and withdrawal with the changes of symptoms scores,blood urea nitrogen(BUN).serum creatinine(Scr),uric acid(UA), albumin (ALB). Using eGFR(CKD-EPI formula) and Scr to evaluate the renal function.Resultâ‘ The Traditional Chinese Medicine(TCM)pathogenesis of Chronic Renal Failure was kidney deficiency and blood stasis and humid hot. With respect to the primary deficiency syndromes, spleen and kidney Yang deficiency was the most common type,accounter for33%of all the types;followed by both Yin and Yang deficiency(23%),spleen and kidney Qi deficiency(11%). The study have no liver and kidney Yin deficiency. In all excess syndrome types,the dampness heat syndrome were dominant, accounted for37%, followed by blood stasis syndrome (28%) and the dampness syndrome(14%). After different Chinese medicine treatments, the distribution of chronic renal failure syndromes were changed. After treatmented, with respect to the primary deficiency syndromes, spleen and kidney Qi deficiency was the most common type.accounter for34.9%of all the types;in all excess syndrome types,the dampness syndrome were dominant,accounted for39.5%.â‘¡A&A in the treatment of chronic renal failure patients,disease curative effect of3month group,6month group,12month group the total efficiency were34.9%,64%,54.5%,syndromes efficient were47.7%,72%,54.5%.6months of total efficiency was the higest(P<0.05).â‘¢fter A&A treatment CRF patients, the Qi deficiency score, the blood deficiency score, the Yin deficiency score and the integral deficiency syndrome score lower than before treatment(P<0.05). In all excess syndrome types,the dampness syndromes score and excess syndrome score higher than before treatment (P<0.05). According to patients after therapy into effective group and ineffective group, compared with the ineffective group,effective group of deficiency,blood deficiengcy,Yang,Yin,and other symptoms of the virtual integration can significantly reduce(P<0.05). The dampness, and other excess syndrome scores are significantly increased after treatment(P<0.05).â‘£sing eGFR(CKD-EPI formula)and Scr to evaluate the renal function, found that The Scr of3month group,6month group,12month group After treatment than before Treatment were significantly decreased(P<0.05), eGFR before treatment were Significantly elevated compared.⑤Effect of A&A has nothing to do with age, the primary disease and the application of RASI. Gender had significant effect of A&A,multiple linear Regression analysis also showed improvement in renal function in men is more obvious(P<0.05).CKD3~4stages patients were significantly improved renal function,howere not CKD2stages patients.â‘¥ith the prolonged course of treatment,Scr decline gradually increasing (-12.2±12.5â†' -14.1±13.4â†'-18±14.4), eGFR increased rate is also increasing.(19.±19.3â†'21.9±26.7â†'27.8±39.75). Compared with the3month group,eGFR after12months of treatment group increased more significantly (P<0.05). Comparison the Scr,eGFR,total points of three treatment Groups before treatment, after treatment,after stopping, the results showed that, compare with pre-treatment,after treatment Scr were significantly decreased and eGFR was significantly increased(P<0.05). Scr level of6months and3months increased significantly after stopping the treatment(P<0.05).12month group Scr still down significantly,eGFR remained significantly elevated(P<0.05). Conclusion The effect of A&A has protective effect on renal function, can delay the progress of renal function in the role,can decrease Scr,increase eGFR in a certain extent function. A&A can improve CRF patients clinical symptoms of the deticiency. Dampness syndrome may affect the long-term efficacy of A&A. The best course of the A&A treatment is12months,but it need to pre-treatment or treatment within three months plus other traditional Chinese medicin to improve the compatibility. A&A treatment in the clinical application security.no significant side effects.