Clinical Observation Of Modified Shenqi Gan Lu Yin In The Treatment Of DKD With Deficiency Of Both Qi And Yin And Damp-heat (G3A3 Stage) And Its Effect On Cystatin C

Objective:To observe the clinical efficacy of modified Shenqi Ganluyin in the treatment of Diabetic Kidney Disease(DKD)(stage G3A3)with deficiency of both qi and yin and damp-heat,and to further study the changes of serum CystainC(CysC)before and after treatment,so as to evaluate the clinical value of Shenqi Ganluyin on this syndrome type of DKD.Methods:70 patients with deficiency of both qi and yin and damp-heat type of DKD(G3A3 stage)were randomly divided into control group(n=35)and experimental group(n=35).The control group was treated with western medicine,and the experimental group was treated with Shenqi Ganluyin on the basis of the control group.the course of treatment of the two groups was 60 days.The changes of clinical comprehensive curative effect and TCM syndrome curative effect before and after treatment were observed,and CysC,before and after treatment were compared.Serumcreatinine(scr),Urinaryalbumin-to-creatinineratio(ACR),eGFR,urineα1-microglobulin,N-acetyl-β-D-glucosaminidase(NAG),blood glucose,blood lipids and TCM syndrome scores,and the results were statistically analyzed.Result:(1)The levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin,ACR,urine α1-MG,NAG in the two groups after treatment were significantly lower than those before treatment(P<0.01).There was significant difference between the two groups after treatment,and the treatment group was superior to the control group(P<0.05).(2)Total cholesterol,triglycerideand low density lipoprotein decreased and high density lipoprotein increased after treatment in the two groups,but there was no significant difference between the two groups after treatment.(3)The CysC and Scr of the two groups after treatment were slightly lower than those before treatment,and the eGFR of the test group after treatment was slightly higher than that before treatment,and the eGFR of the control group after treatment was basically the same as that before treatment,and there was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups after treatment.(4)The score of TCM syndrome in the two groups after treatment was lower than that before treatment,and the difference was statistically significant(P<0.01).There was significant difference between the two groups after treatment,and the treatment group was better than the control group(P<0.01).(5)The effective rate of TCM syndrome in the experimental group was 87.88%,which was better than that in the control group(72.73%),and the difference was statistically significant(P<0.05).(6)The clinical effective rate of the test group was 84.85%,which was better than that of the control group(63.64%),and the difference was statistically significant(P<0.01).Conclusion:(1)Shenqi Ganluyin combined with western medicine can more effectively improve the clinical symptoms and signs of DKD(stage G3A3)patients with deficiency of both qi and yin and damp-heat type,and reduce the score of TCM symptoms.(2)Shenqi Ganluyin combined with western medicine can more effectively reduce the levels of ACR,urine α 1-MG,NAG and blood glucose in patients with DKD(stage G3A3)of deficiency of both qi and yin and damp-heat type(stage G3A3),suggesting that Shenqi Ganluyin can reduce urinary protein,protect renal tubular function and improve glucose metabolism.(3)Shenqi Ganluyin combined with western medicine can slightly reduce CysC and Scr,and increase eGFR,in patients with DKD(stage G3A3)of qi-yin deficiency and damp-heat type,but there is no difference between the treatment group and the control group.(4)It was found that there were no obvious side effects and adverse reactions after taking Shenqi Gannan Yin for 2 months,which indicated that the safety of this product was good.