The Clinical Research On The Therapeutic Methods And The Mechanism Of Yang-Deficiency Syndrome Of Chronic Renal Insufficiency

Objective:This research focuses on the comparative study of two therapeutic methods (warming Yang and discharging dampness, invigorating Qi and discharging dampness) by observing their effects to the renal function and thyroid hormone of patients with renal failure. To define the therapeutic rule of chronic renal insufficiency of Yang-deficiency syndrome in spleen and kidney and also explore the mechanism.Methods:Forty patients with chronic renal insufficiency of Yang-deficiency syndrome in spleen and kidney are randomly divided into two groups, each twenty cases. Group A is treated with the method of warming Yang and discharging dampness, and Group B is treated with the method of invigorating Qi and discharging dampness. Both of the two groups are observed for two therapeutic courses, which last for six weeks. Major observed indicators include the changes of clinical symptoms and signs, renal function, hemoglobin, thyroid hormone and urine creatinine before and after treatment.Results:(1)The clinical symptoms and signs of Group A are significantly improved after treatment, with the total effective rate of 90%, excellently-effective rate of 15%. Group B are significantly improved after treatment, with a total effective rate of 85%, excellently-effective rate of 5%. Both of the two methods have no significant difference in improving fatigue and lack of strength, eat less and anorexia. Group A has a better therapeutic effect of ache and weak at waist and knee, cold extremities, abdominal fullness and distention,cold pain of the waist, clear abundant nocturia than Group B, while Group B has a better therapeutic effect of short of breath and distinclination to talk than Group A. (2) Both of the two methods can effectively decrease the level of BUN and Scr, increase Hb level, thus improving renal function and anemia status. (3) The therapeutic method of warming Yang and discharging dampness can regulate thyroid hormone levels, thus improving symptoms of Yang-deficiency syndrome. (4) Both of the two therapeutic methods have no significant effect in K+,CO2CP,UA,Ucr. (5) Side effects are detected neither in Group A nor in Group B during the consecutive six weeks of treatment, so the short-term security can be ensured.Conclusions:Both two therapeutic methods of warming Yang and discharging dampness and invigorating Qi and discharging dampness can effectively treat chronic renal insufficiency of Yang-deficiency syndrome in spleen and kidney. While the therapeutic method of warming Yang and discharging dampness is the inheritance of TCM treatment based on syndrome differentiation. The therapeutic method of invigorating Qi and discharging dampness is the innovation and challenge of TCM treatment based on syndrome differentiation. As long as an accurate grasp of adaptation disease, an appropriate use of dosage and therapeutic course, the clinical application will be safe and convenient.