| ObjectiveOn the basis of many years of clinical observation and consulting a large number of literature,according to the pathogenesis characteristics of chronic glomerulonephritis(spleen and kidney qi deficiency with blood stasis syndrome),this paper takes strengthening spleentonifying kidney-astringent essence-expelling blood stasis as the treatment method,and selects the effective prescriptions used by my tutor for decades as the treatment.Objective To observe the clinical efficacy of Jianpi Yishen Shejing Huayu decoction in the treatment of chronic glomerulonephritis(spleen and kidney qi deficiency with blood stasis syndrome)and its effect on proteinuria,and to evaluate the effect of this decoction on hypercoagulable state and microinflammatory state;to explore the correlation between the improvement of hypercoagulable state and microinflammatory state with proteinuria in chronic glomerulonephritis.Objective to explore the mechanism of Jianpi Yishen Shejing Huayu decoction in the treatment of chronic glomerulonephritis(spleen and kidney qi deficiency with blood stasis syndrome)with proteinuria,and provide new ideas and clinical demonstration for the treatment of chronic glomerulonephritis with traditional Chinese medicine.Methed1.Randomly divided 60 Patients with chronic glomerulonephritis proteinuria(spleen and kidney qi deficiency with blood stasis syndrome)into treatment group and control group,30 in each group.there was no significant difference between two groups of patients in general information such as:age,gender,course of disease,kidney function and curative effect observation index and TCM syndrome score(P>0.05).2.Patients in the control group were given basic treatment(including regular work and rest,low-salt and low-fat high-quality protein diet,control blood pressure and reduce urinary protein,oral valsartan capsules;avoid the use of drugs that affect renal function and nephrotoxicity).The patients in the treatment group were given Jianpi Yishen Shejing Huayu decoction on the basis of the treatment in the control group.Two groups of patients were observed and statistical results after 8 weeks of treatment.3.The 24 hours urinary protein,microalbuminuria,blood fat(cholesterol,triglyceride,high density lipoprotein,low density lipoprotein),hs-CRP and other indicators of the two groups before and after treatment were analyzed,and the TCM symptoms quantization table was filled in.The change of each index and TCM syndrome of the two groups before and after treatment were analyzed and compared.Result1.In terms of clinical efficacy:The total effective rate of the treatment group was 86.67%.which was significantly higher than 53.33%of the control group(P<0.05).2.According to TCM syndrome score,the total effective rate of TCM syndrome improvement was 56.67%in the control group and 86.67%in the treatment group,with significant difference(P<0.05).There was no significant difference in TCM syndrome score between the two groups before treatment(P>0.05).After treatment,the TCM syndrome scores of the control group and the treatment group decreased in varying degrees.Compared with the control group,The treatment group was more effective in improving TCM syndromes.The difference was significant(P<0.05).In terms of specific syndrome scores,except for dark complexion and numbness of limbs,the control group and the treatment group had varying improvement in various TCM syndrome scores.There was significant difference between the two groups(P<0.05);compared with the control group,the treatment group had shortness of breath and lazy speech,edema,reduced appetite,stomach distension and urine Frequency and other spleen and kidney qi deficiency symptoms improved most significantly.The difference was significant,(P<0.01)3.In terms of reducing urinary protein,there was no significant difference in 24-hour urinary protemn and urinary microalbumin between the two groups before treatment(P>0.05).After treatment,24-hour urinary protein and urinary microalbumin in the control group and the treatment group decreased in varying degrees,while in the control group,24hour urinary protein and urinary microalbumin in the treatment group decreased more significantly(P<0.05).4.In terms of improving hypercoagulability,there was no significant difference in cholesterol,triglyceride,high-density lipoprotein and low-density lipoprotein between the two groups before treatment(P>0.05).After treatment,there was no significant change in cholesterol and low-density lipoprotein in the control group compared with before treatment while in the control group,cholesterol and low-density lipoprotein in the treatment group decreased in varying degrees,with significant difference(P<0.05).After treatment,triglycerides in the control group and the treatment group decreased in varying degrees,but there was no significant difference between the two groups(P>0.05).After treatment.high density lipoprotein in the two groups increased in varying degrees,compared with the control group,high density lipoprotein in the treatment group increased more significantly,the difference was significant(P<0.05).5.In terms of microinflammation,there was no significant difference in hs-CRP between the two groups before treatment(P>0.05).After treatment.the hs-CRP in the control group and the treatment group decreased in varying degrees.Compared with the control group,the hs-CRP in the treatment group decreased more significantly(P<0.05).6.In terms of the correlation between hypercoagulability.microinflammation and urinary protein,according to Pearson correlation analysis,cholesterol,triglyceride,lowdensity lipoprotein and hs-CRP were positively correlated with 24-hour urinary protein,with correlation coefficients of 0.352,0.455,0.339 and 0.741(P=0.006,0.000,0.008,0.000);there has negative correlation between high-density lipoprotein and 24-hour urinary protein,with correlation coefficient of-0.284(P=0.028).ConclusionJianpi Yishen Shejing Huayudecoction can not only significantly improve the clinical symptoms of chronic glomerulonephritis(spleen and kidney qi deficiency with blood stasis syndrome),but also reduce the urinary protein,blood fat and hs-CRP.On the one hand,it can reduce blood fat,so as to reduce blood viscosity,improve renal microcirculation and improve hypercoagulable state.On the other hand,it can reduce the level of hs-CRP,reduce micro inflammation,so as to reduce the leakage of urinary protein and protect renal function.Therefore,compared with the conventional Western treatment,Jianpi Yishen Shejing Huayu decoction has certain advantages in relieving clinical symptoms,reducing proteinuria and improving prognosis. |
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