Study On The Rule Of Syndrome Differentiation Of Early Diabetic Nephropathy Based On Innovative Expert Opinion

Objective: Using modified Delphi method, based on the survey of first tworounds,to make the third round of "Traditional Chinese Medicine (TCM) diagnosisand treatment of early Diabetic Nephropathy(DN) based on the law of the natureof the virtual machine stasis disease" expert questionnaire. Through researchingand analyzing typical symptoms, lesions, syndrome differentiation, treatmentprinciples of early DN, finally to synthesize three rounds’ expert consultationquestionnaire results of statistical analysis, to make a summary of the syndromeand law of early DN.Methods: In this study, the first round expert consultation questionnaire wasformed through group members’ discussing on the basis of preliminary literaturereview, sorting and screening. After receiving the reply, we made statisticalanalysis of the results of the consultation then the second round of expertconsultation questionnaire was formed. The third round of consultationquestionnaire was formed after comprehensive analysis of the results andopinions of the second round Firstly, we established a database with EXCEL, thenused SPSS17.0statistical package to import the database and to proceed thestatistical analysis. We observed concentration degree and coordination degreeof the experts’ opinion, also focused on the reliability indices of consultationquestionnaire. Through screening and sorting out the counseling entries toinitially reveal the therapy regularity of early DN.Results:1.Experts survey results of three rounds showed that experts’ positivecoefficient was100.00%, which indicated that these experts paid more attentionto the study.2.The reliability of three rounds consultation questionnaires were between0.7-0.98, which reminded high internal consistency of the questionnaires. 3.Through comprehensive analysis of the results of three rounds questionnaires,the therapy regularity of early DN was formed initially.The syndromecharacteristics of early DN were formed as follows: nocturia, fatigue, frequenturination, soreness and weakness of waist and knees, hand-foot chills, feelingheavy in the head and body, edema, thirst with liking for fluids, back pain,numbness of the limbs, shortness of breath lazy words, insomnia, being perturbed.The related laboratory examination indexes of early DN were described in turn.Microalbuminuria,24h urinary albumin excretion rate, routine urine test,urinary albumin/creatinine, glycosylated hemoglobin,blood lipids, ions(K+, Na+, Cl-, Ca2+, Mg2+, P3+), fasting plasma glucose,2h postprandial bloodglucose, serum albumin, serum creatinine, blood urea nitrogen.The main lesionsof early DN were: Kidney, meridian, spleen.Synrome differentiation andclassification of early DN were as follows: Qi deficiency and blood stasis,deficiency of both Qi and Yin, insufficiency of both the spleen and the kidney,kidney Qi deficiency, Qi and Yin deficiency of both the spleen and the kidney,kidney Yin deficiency,kidney Yang deficiency.Therapeutic Methods of early DNwere as follows: nourishing spleen and kidney and activating blood flowtherapy,supplementing Qi, nourishing Yin and promoting blood circulation method,activating blood circulation method,nourishing kidney and promoting bloodcirculation to dredge collaterals method, supplementing kidney and nourishingspleen method,supplementing Qi and nourishing Yin method,supplementing Qi andactivating blood circulation method, supplementing kidney and fixing spermmethod,warming kidney and nourishing spleen method.Conclusion:1.The questionnaire survey data demonstrated high levels of these experts’enthusiasm and professional standards, high reliability and great coordinationof their professional advices.2.through which symptom and treatment rules of early DN such as syndrome, diseaselocation, syndrome type, therapy, diagnostic criteria were initially formed for your reference.