Acute Kidney Injury Based On Clinical Efficacy Of Chronic Kidney Disease Treatment, "reconciliation Shaoyang, Tom Lee Triple Burner" Method

BackgroundAcute-on-Chronic kidney disease is not uncommon in clinical, is accompanied by complicated symptoms and serious complications, with high incidence of endpoint events and a high degree of risk. The treatment of modern medicine for Acute-on-Chronic kidney disease emphasizes on the removal of the causes and improving the complications, and which can restore or delay the progression of the renal function is still being explored. The research of traditional Chinese medicine for Acute-on-Chronic kidney disease is still in infancy. It should be imperative to look for an effective way under the participation of the traditional Chinese medicine. Based on the clinical research of hejie-fa delaying the progression of the renal function and the TCM syndromes elements of A/C, this research is committed to confirm the clinical efficacy of A/C with the treatment of "hejie shaoyang, tongli sanjiao".ObjectiveTo explore the difference in prognosis of Acute-on-Chronic kidney disease and Acute kidney injury. To confirm the the clinical efficacy of A/C with the treatment of "Hejie Shaoyang, Tongli Sanjiao". MethodsReseach1Analysis the prognosis of A/C and AKIPatients, met the inclusion criteria, in Guang’ anmen Hospital,China Academy of Chinese Medical Science from March1,2013to February30,2014. We collect all patients’general information, laboratory parameters, TCM symptoms, clinical outcomes, using descriptive study? according to"the guiding principle on Chinese traditional medicine new drug clinical research"and the TCM syndrome on AKI in2009, confirm the TCM syndrome and analysis the difference in prognosis of A/C and AKI.Reseach2Observe the clinical efficacy of A/C with the treatment of "hejie shaoyang, tongli sanjiao"Patients, met the inclusion criteria, in Guang’anmen Hospital,China Academy of Chinese Medical Science from March1,2013to February30,2014. By method of prospective, open, concurrent controlled study, the treatment group and the control group are divided according to the actual situation. The two groups are collected including general information, laboratory parameters, TCM symptoms, clinical outcomes and renal function outcomes, to validate clinical efficacy of the treatment of "hejie shaoyang, tongli sanjiao".ResultsReseach1Analysis the prognosis of A/C and AKI 1. According to the information of93cases of AKI patients met the inclusion criteria, male61cases, female32cases, the ratio of male to female is approximately1.9:1. Mean age is54.94±19.72. BMI is24.25±3.96. In the basic diseases, along with hypertension are in the first(75.29%), followed by hyperlipidemia,cardiovascular disease,digestive disease,2diabetes, respiratory disease and ureter,bladder,urinary tract disease,cancer.2. The incident of the chronic basic diseases and complications in the two groups show, hypertension and anemia, calcium and phosphorus metabolism, hyperkalemia, the prevalence rate of which A/C is significantly higher than AKI, and there is statistical difference(P<0.05).3. TCM syndrome elements of93patients show: the deficiency origin syndromes are mainly Qi deficiency syndrome, followed by Yin deficiency, yang deficiency, xue deficiency. The excess syndromes are mainly wet, followed by heat, blood stasis, qi stagnation, pathogenic wind. TCM symptom scores show, after treatment, compared with A/C, alone AKI’symptom scores improve significantly(P<0.05), which is consistent with the outcomes of alone AKI patients——alone AKI patients have a better prognosis than A/C patients(P=0.002).Reseach2Observe the clinical efficacy of A/C with the treatment of "hejie shaoyang, tongli sanjiao"1. In A/C patients, male46cases, female20cases, the ratio of male to female is approximately2.2:1. Mean age is54.02±18.81. In the basic diseases, hypertension is in the first place (83.33%), followed by cardiovascular disease,2diabetes and so on. And hypertension, cardiovascular disease are related with clinical outcome. In the complications, anemia accounts for the first one, the rest including metabolic acidosis, infection, electrolyte imbalance and cardiovascular events.2. The causes of A/C are mainly renal factor, followed by pre-renal factors, the post-renal factors are least. There are differences in incentives between the two groups. The incentives in the treatment group are infection, drug, surgery, and which in the control group are drug, infection, surgery.3. TCM syndrome elements of A/C patients show: the deficiency origin syndromes are mainly Qi deficiency syndrome, followed by Yin deficiency, yang deficiency, xue deficiency. The excess syndromes are mainly wet, followed by heat, blood stasis, pathogenic wind. There is no difference in these two groups. TCM symptom scores show, compared with the control group, the symptom scores of the treatment improve significantly(P=0.004).4. The level of renal function of two groups show, there is no statistical difference in basic renal function(P>0.05). The basic Scr and BUN has a higher level in control group, and in which the HD patients are more than the treatment group when A/C(P=0.073). But there is no difference in the renal function when A/C. After treatment(P>0.05), the renal function of both groups reduces obviously but there is no statistical difference between them(P=0.182). And the renal function of the treatment group improves more significant than the control group.5. There is significant difference between both groups in clinical outcomes (P=0.026). The treatment group(65.63%)is better than the control group(38.24%)in clinical efficiency. And the survival function shows, the treatment group is better than the control group.Conclusion1. Alone AKI patients have a better prognosis than A/C patients, it is the same to TCM symptom score.2. The treatment of A/C by He-Jie-Fang can decrease the level of Scr, improve GFR, improve TCM symptom and clinical outcomes, reduce the incident of endpoint events.