| Objective: To comprehensively evaluate the effect of traditional Chinese medicine syndrome differentiation combined with basic therapy on CPGN through real-world research and design,and provide objective and realistic data for the clinical study of integrated Chinese and Western medicine treatment of this disease.Methods: Through the nephrology ward of the Central Hospital of Shandong Provincial Hospital and the Department of Nephrology of Shandong Provincial Hospital of Traditional Chinese Medicine,the patients were screened by inclusion and exclusion criteria,and divided into two groups,depending on whether they were actually treated with traditional Chinese medicine decoction.One is the observation group(Chinese medicine soup)Agent + basic treatment),and the other one is the control group(basic treatment).The observation treatment course of these two groups was no less than six months.Data was then collected and a database was established.After this,the statistical analysis software was adopted to sort and analyze the data to observe the actual effect of traditional Chinese medicine syndrome differentiation plus basic treatment for CPGN in real and complex medical environment.Results: A total of 228 cases were collected,including 105 cases in the observation group and 123 cases in the control group.The observation group had a longer course of disease,and the average age of the patients was 51.03 years.The average age of the patients in the control group was 41.91 years old,and the majority of the patients in this group had a disease duration that was than half a year.The proportion of renal biopsy in the observation group was significantly smaller than that of the control group.Among all of the 228 patients,29 showed comorbidities.The top five frequently occurring diseases were hypertension,type 2 diabetes,benign prostatic hyperplasia,hyperlipoproteinemia and cerebral infarction.Five types of most-used of medicines were observed.The observation group used: ACEI and ARB,immunoregulatory Chinese patent medicine,improvement of glomerular microcirculation drugs,clearing heat and dampness Chinese patent medicine,supplementing qi and nourishing yin Chinese patent medicine.The control group used: ACEI and ARB,anti-allergic medicine,hemostatic medicine,immunoregulatory Chinese medicine,improvement of glomerular microcirculation drugs.Ten types of the most-used medicines were also observed.The observation group used:Huangkui Capsule,Bailing Capsule,Danshen Ligustrazine Injection,Nephritis Rehabilitation Tablet,Tripterygium Glycosides,Calcium Carbonate D3 Tablet,Valsartan Capsule,Atorvastatin Calcium Tablets,pantoprazole sodium enteric-coated tablets,furosemide tablets;The control group used: Bailing capsule,calcium gluconate injection,vitamin K1 injection,valsartan capsule,benazepril tablets,rosuvastatin Calcium tablets,calcium carbonate D3 tablets,Shenkangning capsules,prednisone acetate tablets,piperazine ferulate tablets.In the observation group,the syndrome of spleen and kidney qi deficiency was the largest,and the proportion of damp-heat syndrome was the largest in the standard.Both of the spleen-kidney qi deficiency with damp-heat syndrome and spleen-kidney qi deficiency with water wetness certificateaccounted for the largest proportion;five most-used Chinese medicines were: tonic medicine,clearing damp and promoting diuresis medicine,heat-clearing medicine,blood-activating phlegm medicine,and phlegm-removing medicine;ten most-used Chinese herbal medicine pieces were:poria cocos,astragalus mongholicus,licorice,salvia,pyrrosia lingua,angelica,psyllium,rosa laevigata michx,atractylodes,yam.The total effective rate was 78.51% in the 2 months of treatment,80% in the observation group and 77.24% in the control group.The total effective rate was 72.81% in the 6 months of treatment,77.14% in the observation group and 69.11% in the control group.There was no significant difference in the clinical efficacy between the two groups.After 2 months and 6 months of treatment,the TCM syndrome scores were significantly improved in both groups,and the effect of the 6-month treatment was significantly better than that of the 2-month treatment.The effect of the observation group was significantly better than that of the control group.At the 2nd and 6th months of treatment,the two groups could significantly improve the24-hour urine protein quantitation.The effect of the observation group was significantly better than that of the control group at 6 months.The two groups were treated for 6months and 2 treatments for improving 24 h urine protein quantitation.There was no significant difference at 6 months compared with 2 months.After 2 months and 6 months of treatment,the observation group and the control group could significantly reduce urinary red blood cells,and the effect of treatment for 6 months was significantly better than that of 2 months after treatment;the effect of the observation group was significantly better than that of the control group at 2 months of treatment.The effect is equivalent at 6months.After 2 months and 6 months of treatment,the observation group and the control group could significantly improve serum creatinine.There was no significant difference between the two groups at 6 months.There was no significant improvement in serum creatinine between the two groups at 6 months and 2 months.Serum creatinine of the control group increased compared with 2 months of treatment.Treatment of 2 months of both groups can significantly improve blood urea nitrogen,but there is no significant difference between the two groups;treatment of the observation groupcan significantly improve blood urea nitrogen at 6 months,and the control group is significantly better than observation.There was no significant difference in the treatment effect between the two groups at 2 months and 6 months.Conclusion: The traditional Chinese medicine syndrome differentiation combined with basic treatment can significantly reduce the 24-hour urine protein and urinary red blood cells of patients,and improve the renal function of patients;the syndrome of chronic nephritis with spleen and kidney qi deficiency and dampness heat syndrome is the most;the five most widely used traditional Chinese medicines in clinical practice are: tonic medicine,clearing damp and promoting diuresis medicine,heat-clearing medicine,blood-activating phlegm medicine,and phlegm-removing medicine;the most used 10 Chinese herbal medicine pieces are: poria cocos,astragalus mongholicus,licorice,salvia,pyrrosia lingua,angelica,psyllium,rosa laevigata michx,atractylodes,yam,with the effect of qi and water,can be regarded as the basic prescription for the treatment of chronic nephritis;Chinese medicine decoction oral in the elderly patients with long-term disease more. |
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