| ObjectiveTo observe the effect of TCM syndrome differentiation in the treatment of chronic kidney disease fifth stage non-dialysis phase,and to evaluate whether it is safe and effective.MethodsAdopt the method of prospective,non randomized controlled study.In the observation period of 18 months,patients at chronic kidney disease stage 5(primary disease for non diabetic nephropathy)accord with its voluntary acceptance of the syndrome differentiation and treatment of traditional Chinese medicine were divided into treatment group and control group.The treatment group received basic treatment of Western medicine and TCM syndrome differentiation and treatment,and the control group only received the basic treatment of Western medicine.The basic situation,curative effect evaluation index and safety index were compared between the two groups.Results1.There are 24 patients included in treatment group and 10 patients included in Western medicine.As a result,there were 34 cases from two groups entered the analytic stage.2.Curative effect analysis:(1)The length of time patients took from Inclusion to the dialysis:patients in the control group,the delayed length of average time was 5.78 months,and TCM patients took an average of 8.63 months,there were significant differences(P=0.027).It suggests that TCM syndrome differentiation and treatment can delay the chronic kidney disease in the 5 phase of non dialysis patients to enter the dialysis.(2)Quality of life scale integration:?Integral of physiological function:before treatment,the treatment group was 71.59±10.70 points in the field of physiological function.And after treatment,the score of physiological function was 73.05.±8.90 points.Before treatment,the control group was 71.11±9.17 points in the field of physiological function.And after treatment,the score of physiological function was 64.44±11.95 points.There were statistically significant differences in the physiological function of the control group between before treatment and after treatment(P=0.012).The physiological function of the control group was decreased after treatment.The physiological function of the two groups after treatment was statistically significant difference(P=0.035).The physiological function of the treatment group was higher after treatment.This suggests that TCM syndrome differentiation and treatment can maintain the physiological function of patients with chronic kidney disease in the 5 stage of non dialysis to a certain extent.?Integral of mental functionl:before treatment,the treatment group was 71.59±11.38 points in the field of mental function.And after treatment,the score of mental ffinction was 74.73±7.86 points.There were statistically significant differences in the mental function of the treatment group between before treatment and after treatment(P=0.045).The mental function of the treatment group was increased afier treatment.Before treatment,the control group was 74.22±4.74 points in the field of mental function.And after treatment,the score of mental function was 72.67±7.47 points.This suggests that TCM syndrome differentiation and treatment can maintain the mental function of patients with chronic kidney disease in the 5 stage of non dialysis to a certain extent.?Integral of social dimension:before treatment,the treatment group was 71.14±15.29 points in the field of Social dimension.And after treatment,the score of Social dimension was 74.09±11.44 points.Before treatment,the control group was 70.89±12.34 points in the field of Social dimension.And after treatment,the score of Social dimension was 72.33±10.30 points.There was no statistical difference in the social dimension scores between the two groups before and after treatment(P>0.05).?Integral of therapeutic experience:before treatment,the treatment group was 61.41±13.28 points in the field of therapeutic experience.And after treatment,the score of therapeutic experience was 70.68±8.76 points.There were statistically significant differences in the therapeutic experience of the treatment group between before treatment and after treatment(P=0.023).The mental function of the treatment group was increased after treatment.Before treatment,the control group was 68.11±7.87 points in the field of therapeutic experience.And after treatment,the score of therapeutic experience was 67.67±4.90 points.This suggests that with TCM syndrome differentiation and treatment,patients with chronic kidney disease in the 5 stage of non dialysis had better treatment experiences.(3)Nutritional status:?Integral of nutritional status scale:before treatment,the treatlent group was 27.09±3.18 points in the field of nutritional status scale.And after treatment,the score of nutritional status scale was 27.59±2.81 points.Before treatment,the control group was 27.44±3.09 points in the field of nutritional status scale.And after treatment,the score of nutritional status scale was 25.33±2.12 points.There were statistically significant differences in the nutritional status scale of the control group between before treatment and after treatment(P=0.002).The nutritional status scale of the control group was decreased after treatment.The nutritional status scale of the two groups after treatment was statistically significant difference(P=0.039).The nutritional status of the control group after treatment was decreased.This suggests that TCM syndrome differentiation and treatment can maintain the nutritional status of patients with chronic kidney disease in the 5 stage of non dialysis to a certain extent.?Laboratory index of nutritional status:before treatment,the treatment group was 40.76±3.15g/L in the field of plasma albumin level.And after treatment,the level of plasma albumin was 38.51±4.97g/L.Before treatment,the control group was 41.26±2.87g/L in the field of plasma albumin level.And after treatment,the level of plasma albumin was 34.83±3.55g/L.There were statistically significant differences in the plasma albumin level of the control group between before treatment and after treatment(P=0.001).The plasma albumin level of the control group weas decreased after treatment.The plasma albumin level of the two groups after treatment was statistically significant difference(P=0.042).The plasma albumin level of the control group after treatment was decreased.Two groups of patients before treatment and after treatment,compared with no significant difference in the level of pre albumin and body mass index.This suggests that TCM syndrome differentiation and treatment can maintain the plasma albumin level of patients with chronic kidney disease in the 5 stage of non dialysis to a certain extent.3.Safety analysis:two groups of patients before and after treatment,HGB,CO2CP,K,ALT,and AST were not statistically significant difference(P>0.05).During the course of the study,no serious adverse events were observed in the two groups.This suggests that TCM syndrome differentiation and treatment of chronic kidney disease in the 5 phase of non dialysis patients with high clinical safety.Conclusion1.The therapy of CKD5 with traditional Chinese medicine can delay the length of time into the dialysis.2,The therapy of CKD5 with traditional Chinese medicine can improve patient's living quality and nutritional status. |
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