| Objective: the complications and sequelae caused by diabetic nephropathy with atherosclerosis is an important cause of death of renal failure.This study observed the influence of Yiqi Yangyin Huoxue Tongluo method on clinical symptoms,signs,related laboratory ind exes of patients with G3A2 stage diabetic nephropathy with atherosclerosis before and after treatment,so as to provide reference for clinical treatment of diabetic nephropathy with atherosclerosis with Traditional Chinese Medicine Atherosclerosis provides a new and effective method to delay the progress of chronic kidney disease,improve the quality of life of patients and reduce economic pressure.Methods: Sixty patients with G3A2 diabetic nephropathy and atherosclerosis were selected from the outpatient and inpatient affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from June2019 to January 2021.The groups were randomly divided into control group and treatment group,with 30 patients in each group.The control group was treated with conventional western medicine(valsartan capsules 80 mg,atorvastatin calcium tablets 20mg),and the treatment group was treated with Yiqi Yangyin Huoxue Decoction under the above treatment plan.After 12 weeks of treatment,the main observation indicat ors were as follows: safety indicators: blood,urine,stool routine,electrocardiogram,cardiac color Doppler ultrasound,liver function and other indicators,which were tested before and after the experiment;respiratory,heart rate,pulse,blood pressure,body temperature and other basic vital signs were monitored weekly.Curative effect index: Main efficacy indexes: 1)TCM syndrome score;2)lipid metabolism indicators: triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),medium membrane thickness(IMT);secondary efficacy Indicators: 1)glucose metabolism Indicators: fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c);2)renal function indicators: serum creatinine(SCR),estimated glomerular filtration rate(e GFR)and 24-hour urinary albumin were estimated.Results:1.General data: Among the 60 patients in this study,3 cases were dropped from the control group and 3 cases from the treatment group.and the most common disease course in the two groups was 10-15 years.Before treatment,there were no significant differences in gender,age,course of disease and general laboratory indexes between the treatment group and the control group(P>0.05).2.Clinical efficacy of TCM syndrome: The effective rate of TCM syndrome in the treatment group was 88.9%,and the effective rate in the control group was 59.3%.The rank sum test was used to compare z =-2.118,P = 0.034(P<0.05).The TCM syndrome scores in the control group and the treatment group were decreased,but the treatment group was more effective(P<0.05).3.Changes of renal function: after 12 weeks of treatment,there were obviously differences in serum creatinine,glomerular filtration rate and24-hour urinary microalbumin between the treatment grou p and the control group.In the treatment group,serum creatinine decreased from 95.92 ±12.33 to 78.14±5.91umol/L(P<0.01).Glomerular filtration rate increased from43.93±4.21 to 59.89±1.80 ml/min at week 0(P<0.01).The 24-hour urinary microalbumin decreased from 113.11±34.27 to 47.34±16.65mg/24h(P< 0.01),and the treatment group was better than the control group.4.Changes of glucose metabolism: after 12 weeks of treatment,both the control group and the treatment group had a certain effect on fasting blood glucose,and the fasting blood glucose of the treatment group varies from 9.23±1.84 to 8.60±1.94mmol/l,and the fasting blood glucose in the control group decreased from 9.10 ± 1.46 to 8.58 ± 1.33mmol/l,but there was no statistical significance between the two groups(P>0.05),and was not comparable between the two groups;Regarding the regulation of glycosylated hemoglobin,the treatment group decreased from 9.19±0.80 to 9.10±0.81,which was statistically significant(P<0.01),but the control group ha d no significance,which indicated that the control group had no obvious effect in reducing glycosylated hemoglobin,and the treatment group was significantly better than the control group.5.Changes of lipid metabolism:After 12 weeks of treatment,triglyceride and high density lipoprotein in the treatment group and the control group had a certain effect compared withthose at week 0.Triglyceride in the treatment group decreased from 3.44 ± 0.88 to 2.66 ± 1.01 mmol/L,triglyceride in the control group decreased from 3.41±0.92 to 3.18±0.86mmol/L,and HDL in the treatment group increased from 1.26 ± 0.14 to 2.27±0.60mmol/L,HDL in the control group increased from 1.33±0.13 to 2.54±0.31mmol/ L,and the curative effect of the treatment group was more obvious than that of the control group,with significant difference(P<0.05).In terms of total cholesterol and low-density lipoprotein,t-test was used before and after the intervention in the two groups,and the treatment group had statistical difference(P<0.05),but the control group was insignificant,indicating that the treatment group was effective in reducing total cholesterol and low-density lipoprotein,but the control group was invalid.6.TCM symptom score: After 12 weeks of treatment,the control group’s TCM symptom score decreased from 34.52 ±4.10 to 18.44±8.12,and the TCM symptom score of the treatment group decreased from 33.85 ±4.15 to 13.78±5.06.There was significant difference between the treatment group and the control group(P <0.05).In terms of improvement of the main symptom score,the control group and the treatment group had a certain effect(P<0.05),compared with the control group,the treatment group was more significantly obviously(P<0.05),except for self sweating and night sweating(P>0.05);In terms of the secondary symptom score,the control group and the treatment group had a certain effect(P<0.05),and the treatment group was more significantly than the control group(P<0.05),except insomnia and dreaminess,tongue ecchymosis(P>0.05).Conclusion: Yiqi Yangyin Huoxue Tongluo recipe can effectively improve the clinical symptoms of traditional Chinese medicine,24-hour urinary albumin,serum creatinine,glomerular filtration rate,total cholesterol,low-density lipoprotein,high-density lipoprotein,triglyceride and medium membrane thickness in patients with diabetic nephropathy(g3a2 stage)complicated with atherosclerosis,improve the renal function of patients with diabetic nephropathy,and play an important role in delayi ng the progress of the disease It proved that traditional Chinese medicine has significant advantages in the treatment of diabetic nephropathy with atherosclerosis,which is worthy of clinical research and promotion. |
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