Retrospective Analysis Of 84 Cases Of Chronic Renal Failure Treated By Syndrome Differentiation

Objective:Retrospectively of the clinical data of Chronic kidney disease CKD 3 phase caused by primary glomerular disease.The purpose is to observe the curative effect of traditional Chinese medicine on chronic renal failure caused by primary glomerular diseases.To provide scientific basis for differentiation of symptoms and signs of chronic renal failure,under the treatment of traditional Chinese medicine observe the progress of renal function under different levels of blood pressure and proteinuria.Methods:From January 2010 to December 2014 the medical records of outpatient and hospitalized patients with chronic renal failure caused by primary glomerular disease were collected from the Fifth kidney Department of the provience of Heilongjiang traditional Chinese medicine hospital.Use the simplified MDRD formula to calculate the glomerular filtration rate(eGFR).The medical records were strictly screened according to the inclusion criteria and exclusion criteria.The patients' gender,age,TCM syndrome differentiation,systolic and diastolic blood pressure,serum creatinine and urine protein were recorded and observed.Results :1.In 84 patients with CKD3 stage,after treatment compared with that before treatment serum creatinine decreased and glomerular filtration rate increased,and the difference before and after Scr treatment was statistically significant P < 0.05.The difference before and after eGFR treatment was statistically significant P < 0.05.The regression slope of serum creatinine reciprocal(1/Scr)and treatment time was b(0.00001778)>0.2.Each syndrome after treatment compared with before treatment Scr all decreased,eGFR are rising,the spleen and kidney deficiency syndrome group and spleen kidney both deficiency,dampness and blood stasis syndrome group of Scr,eGFR was statistically significant difference before and after the treatment P < 0.05.Among all syndromes,those with slope b greater than or equal to 0 account for 55.6% of the dampness and turbidity intrinsic syndromes,64.3% of the stasis internal syndromes,58.3% of the dampness and heat wound Yin syndromes,75% of the spleen and kidney qi deficiency syndromes,and 71.4% of the spleen and kidney deficiency and the dampness and blood stasis syndromes.the dampness and turbidity intrinsic syndromes,the stasis internal syndromes,the dampness and heat wound Yin syndromes,the spleen and kidney qi deficiency syndromes,and the spleen and kidney deficiency and the dampness and blood stasis syndromes' serum creatinine reciprocal(1/Scr)and treatment time's regression slope of b was all greater than 0.3.The Scr of patients with different degrees of proteinuria decreased after treatment compared with that before treatment,and the eGFR increased.The difference in Scr and eGFR between the proteinuria + group and the proteinuria + group before and after treatment was statistically significant P < 0.05.There was no statistically significant difference in Scr and eGFR in the urinary protein+++ group before and after treatment P > 0.05.The proportion of those with slope b greater than or equal to 0 in proteinuria group with different degrees account for was 92.3% in proteinuria + group,69.2% in proteinuria + group,and 50% in proteinuria +++ group.In the urine protein + group,the urine protein ++ group,serum creatinine reciprocal(1/Scr)and treatment time's regression slope of b were all greater than 0.In the urine protein +++ group serum creatinine reciprocal(1/Scr)and treatment time's regression slope of b was less than 0.4.Before and after treatment,the blood pressure < 130/80 mmHg group Scr decreased and eGFR increased after treatment compared with that before treatment.The difference in Scr and eGFR before and after treatment was statistically significant P < 0.05.There was no statistically significant difference in Scr and eGFR between the groups with blood pressure ?130/80 mmHg before and after treatment P > 0.05.The proportion of patients with slope b greater than or equal to 0 in different blood pressure groups account for was 60.4% in the blood pressure?130/80 mmHg group and 72.2% in the blood pressure < 130/80 mmHg group.In group of blood pressure < 130/80 mmHg The serum creatinine reciprocal(1/Scr)and treatment time's regression slope of b was greater than 0.In group of blood pressure ?130/80 mmHg The serum creatinine reciprocal(1/Scr)and treatment time's regression slope of b was less than 0.Conclusion:1.Use dialectical treatment to chronic renal failure patients can reduce serum creatinine and increase glomerular filtration rate to a certain extent.2.In the early stage of chronic renal failure,the syndrome of spleen and kidney qi deficiency and the syndrome of spleen kidney deficiency,dampness and blood stasis are better than other syndromes.3.Under TCM dialectical treatment,effective control of proteinuria and blood pressure is beneficial to delay the progression of chronic renal failure.