Clinical Research Of Xiaobai Decoction On The Treatment Of Proteinuria In Patients With Chronic Glomerulonephritis(CKD Stages 1-2)

Objective: To observe the clinical effect of Xiaobai Decoction on chronic glomerulonephritis(CKD stages 1-2),and to investigate its influence on renal tubular injury,to verify the efficacy of Xiaobai Decoction on proteinuria and renal tubular injury.Methods: 100 patients with chronic glomerulonephritis(CKD stages 1-2)with deficiency of spleen and kidney as well as damp-heat and blood stasis were randomly divided into control group(50 cases)and treatment group(50 cases).The control group was treated with integrated basic treatment of Western medicine,while the treatment group was treated with Xiaobai Decoction on the basis of integrated basic treatment of Western medicine for 6 months.Clinical symptoms,TCM syndrome scores,renal function(serum creatinine,glomerular filtration rate,urea nitrogen),24-hour urinary protein quantification,24-hour urinary microalbumin,glomerular protein observation index(urinary microalbumin,Ma/Cr),tubular protein observation index(urinary N-hexanoyl-?-glucoamylase,urinary retinol binding protein,urinary ?1-microglobulin,?2-microglobulin)were observed before and after treatment.Result: Compared with proteinuria in patients with chronic glomerulonephritis(CKD stages 1-2),the total clinical effective rate in treatment group was 95.7%,higher than 89.4% in control group(P<0.05);the total effective rate of TCM syndromes in treatment group was 91.49%,higher than 53.19% in control group(P<0.01);the e GFR in treatment group was higher than before treatment(P<0.05),and the Scr was lower than before treatment(P<0.05).In the control group,e GFR increased(P>0.05)and Scr decreased(P<0.05)compared with that before treatment.There was significant difference between the two groups after Scr treatment(P<0.05),and there was no significant difference among two groups(P>0.05).There was no significant difference between Bun and Alb before and after treatment(P>0.05).The 24 UPro,MA,MAU,Ma/Cr,NAG,RBP,?1-MG and ?2-MG in the treatment group and the control group were all lower than those before treatment(P<0.05),but the difference was more significant in the treatment group(P<0.01).There was significant difference between the two groups in urinary protein observation index after treatment(P<0.05),and the difference between 24 UPro,MA,NAG,RBP,?1-MG and ?2-MG was more significant(P<0.01).There was significant difference in 24 UPro between the treatment group and before treatment at the 4th month(P< 0.05),and from the 5th month after treatment(P<0.01),while there was significant difference in 24 UPro between the control group and before treatment at the 5th month(P<0.05).e GFR was negatively correlated with 24 UPro,NAG,RBP and ?1-MG(P<0.05);after treatment,there was no significant difference in Hb,RBC,Hct,ALT,AST,TC,TG and K+(P>0.05).Conclusion: Xiaobai Decoction can effectively improve the clinical efficacy and TCM syndromes of chronic glomerulonephritis(stages 1-2)with deficiency of spleen and kidney as well as damp-heat and blood stasis.Xiaobai Decoction can improve the renal tubular injury index ?1-MG,?2-MG,NAG,RBP and glomerular injury index MAU,Ma/Cr.e GFR was negatively correlated with 24 UPro and renal tubular injury index NAG,RBP and ?1-MG,Xiaobai Decoction can significantly reduce 24 UPro and MA,stabilize or improve e GFR,which proved that Xiaobai Decoction could reduce the independent risk factors in the process of chronic kidney disease and postpone the progression of chronic kidney disease.by reducing proteinuria and improving renal tubular function.