Clinical Study Of Yiqitongluo Decoction On Stage G3a Of Diabetic Kidney Disease

Objective: To observe with the principle of Supplementing Qi and activating blood circulation and removing blood stasis,the clinical effect of Yiqitongluo Decoctionon treating diabetic kidney disease(DKD)with G3 a phase,and to provide an effective method for the treatment of DKD G3 a stageMethods:After a two-week washout period of 84 patients with DKD stage G3 a diagnostic standard,according to the order of treatment with a ratio of 1:1 were divided into experimental group and control group of 42 cases.The test group in the basic treatment of Western medicine combined with Yiqitongluo Decoction,one dose daily,twice times a day,and the control group in the basic treatment of Western medicine combined with Valsartan Capsules,80 mg/ tablets,1-2 tablets daily,two groups were treated for 18 months.Before and after treatment,first,3,6,9,and 12 months in the same period of the correlation between the indicators,and then compared with the treatment before and after the end of the treatment of TCM symptoms and signs score.To observe the renal insufficiency and renal function progress,end point events and the incidence of adverse reactions including laboratory tests including urinary albumin and creatinine ratio(ACR),β2-microglobulin(β2-MG),Cystatin C(Cys-C),serum creatinine(Scr),and calculated glomerular filtration rate.Results: a total of 83 cases in the control group and the experimental group were observed.(1)there was no significant difference between the two groups before and after treatment,and there was no significant difference in the scores of symptoms and signs(P>0.05).(2)the ACR data of the two groups decreased significantly after treatment 3 months.After 1 month of treatment,the experimental group and the control group ACR compared with the baseline were improved(P < 0.05),and the test group decreased more significantly,the same period between the two groups was statistically significant(P < 0.05).After 3 th month of treatment,with the gradual extension of the course of disease,the urine ACR of the two groups were lower than the baseline.Ninth and 12 th month were more stable than baseline,and the difference was not statistically significant(P > 0.05).Compared with the control group(P < 0.05),the improvement of the experimental group was better than that of the control group in the same period of first to 12 months(P < 0.05).(3)After treatment,the serum β2-MG and Cys-C of the two groups were decreased,and the follow-up of 9th and 12 th month tended to be stable.Compared with the baseline,the experimental group 3th month after treatment the improvement was statistically significant(P < 0.05);the control group for 6th month since the improvement was statistically significant(P < 0.05);in comparison with control group,experimental group 6 months after treatment the serum β2-MG and Cys-C compared with the control group improved statistics the significance(P < 0.05).(4)There was no significant difference between the experimental group and the control group(P < 0.05)after the end of the follow-up,the difference between the experimental group and the control group was not significant(P > 0.05)in the Scr index.(5)After treatment for 12 months,there was no significant difference between the experimental group and the baseline(P > 0.05).The control group e GFR was slow to decline,compared with the experiment group,the difference was not statistically significant after 12 months(P > 0.05)(6)The clinical symptoms and signs of TCM group were better than those of the control group(P < 0.01).The total effective rate of the experimental group was 81%,and the total effective rate of the control group was 36.6%.(7)Two groups of patients without renal insufficiency occurred during follow-up in two groups;there were 3 cases of patients with renal events,1 cases of test group and 2 cases in control group.There was no significant difference(P > 0.05).There are 3 cases of patients with end point events of the two groups.1 cases of test group and end point event rate is 2.38%.The control group in 2 cases,end point event rate was 4.88%.There was no significant difference(P > 0.05).(8)The incidence of adverse reactions in the control group was 9.76%,and that of the experimental group was lower than that of the control group(2.38%).The difference was statistically significant(P < 0.05).Conclusion: Yiqitongluo Decoction with supplementing qi and activating blood circulation to remove blood stasis for the treatment principle,long-term use can reduce urinary protein,renal function remained stable,delaying the progress of the course of DKD,improve the survival rate,improve clinical symptoms and reduce adverse reactions,the long-term curative effect is better than Valsartan Capsules.