A Summary Of The Clinical Experience Of Shengqing Jiangzhuo Therapy For Diabetic Nephropathy

Objective:By observing changes in proteinuria,renal function and clinical symptoms of 27 diabetic kidney disease(DKD)patients treated by Professor Liu Ximing,who used the method of "Shengqingjiangzhuo",summarize Professor Liu Ximing’s basic ideas and clinical experience in using the method of " Shengqingjiangzhuo" to treat DKD.This research intended to provide some ideas and methods for the treatment of DKD in traditional Chinese medicine.Method:1.From September 2015 to March 2018,a total of 27 cases accorded with DKD inclusion criteria were collected.All cases were given health management,basic antihypertensive and hypoglycemic treatment measures,combined with Shengqingjiangzhuo Therapy.The cases and detection indexes were collected at the four observation points at 0,4,8,and 12 weeks.Glomerular filtration rate,urinary albumin/creatinine value,serum creatinine,urea nitrogen,TCM symptom scores were observed.2.Standardize the collected data into Excel 2007 to create a database.3.Statistical analysis of the collected case data was conducted using self-control methods.4.To sum up Professor Liu Ximing’s basic thoughts and clinical experience in treating DKD using the method of " Shengqingjiangzhuo."Conclusion:1.General Information:Of the twenty-seven DKD G3-4A3 patients with spleen and kidney qi deficiency syndrome,63%were male patients and 37%were female patients.Most patients were in middle or old ages.2.Detection indicators:Renal function:After 12 weeks of treatment,creatinine,uric acid,and glomerular filtration rate were significantly different from those at the time of initial diagnosis(P<0.01).Urea nitrogen was not statistically different.The average values of creatinine and uric acid were(181.46±67.59)umol/L and(421.90±74.17)umol/L at the time of initial diagnosis,respectively,and dropped to(125.62±52.28)umol/L and(382.63±68.38)umol/12 weeks after treatment.The glomerular filtration rate was(35.46±13.65)ml/(min·1.73m2)at the initial diagnosis,and(53.23± 15.76)ml/(min-1.73m2)after 12 weeks of treatment.Urinary albumin/creatinine ratio:After 12 weeks of treatment,there was a significant difference(P<0.01)compared with the initial diagnosis.The mean value decreased from(525.37±153.63)mg/g at the initial diagnosis to(346.72±91.59)mg/g after 12 weeks.Symptoms of traditional Chinese medicine:After 12 weeks of treatment,the mean scores of TCM symptoms and the main symptoms of fatigue,edema,and nocturia were significantly different from those at the time of initial diagnosis(P<0.01).Blood glucose:After 12 weeks of treatment,fasting plasma glucose and postprandial blood glucose were significantly different from those at the time of initial diagnosis(P<0.01);mean fasting blood glucose was decreased from the initial diagnosis(8.03± 1.81)mmol/L,and was reduced to 12 weeks after treatment.(7.18±1.35)mmol/L;mean postprandial blood glucose was(10.12±1.73)mmol/L from the initial diagnosis and(9.03±1.05)mmol/L after 12 weeks.Blood lipids:After 12 weeks of treatment,total cholesterol and triglycerides had significant differences compared with those at the time of initial diagnosis(P<0.01).Total cholesterol and triglycerides were(5.59±1.69)mmol/L and(2.64±1.28)mmol/L,respectively,at the initial diagnosis,and decreased to(4.68±0.98)mmol/L and(1.96±0.74)mmol,respectively,after 12 weeks of treatment.Blood pressure:After 12 weeks of treatment,both systolic blood pressure and diastolic blood pressure showed a downward trend,which was significantly different from that at the time of initial diagnosis(P<0.01).Conclusion:1.The use of Shengqingjiangzhuo method in the treatment of spleen and kidney qi deficiency syndrome in DKD G3-4A3 can improve renal function,reduce urinary protein,relieve clinical symptoms,and improve blood glucose,blood pressure,and blood lipid levels to varying degrees.2.The basic pathogenesis of DKD is deficiency of the spleen and kidney.The pathogenesis is qi deficiency,yin deficiency,blood stasis,and the disease is closely related to the spleen and kidney.Spleen and kidney deficiency is the fundamental cause,while the retention of water,wetness,turbidity and sputum are the secondary causes.It is manifested as combination of excess and deficiency syndrome,and hard to cure.3.Shengqingjiangzhuo is the core treatment method for DKD.Treatment should focus on reinforcing qi and yin to Shengqing,improving blood circulation and removing dampness to Jiangzhuo.The treatment of shengqing should be the main point,aided by jiangzhuo.Qing went up,then turbidity decreased.