Effect Of Traditional Chinese Medicine On Endpoint In Stage 5 Non-dialysis Patients With Chronic Kidney Disease(Non-dialysis)

ObjectiveThrough the intervention of traditional Chinese medicine in patients with chronic kidney disease stage 5(non-dialysis),we can observe whether it can delay the patient’s entry into the endpoint and improve the clinical efficacy.MethodThe clinical study was conducted in a bidirectional cohort study.Patients with CKD stage 5(non-dialysis)who were treated in Hangzhou Hospital of Traditional Chinese Medicine from December 2014 to December 2017 were selected according to inclusion criteria and exclusion criteria.)Patients with deficiency type were randomly divided into Western and Western groups and Western medicine group,Western medicine group to Western medicine treatment+Jianpi Yishen Fang treatment,Western medicine group to Western medicine treatment,recording two groups of patients before and after treatment for 6 months Indicators,TCM symptom product improvement and the incidence of end events,survival time,to make an analysis.The main laboratory parameters include(serum creatinine,glomerular filtration rate,red blood cell count,hemoglobin,serum albumin,serum potassium).Result1.Symptom comparison:① group comparison:a.Western medicine group compared with before treatment,with significant difference(P<0.01);b.Western medicine group compared with before treatment,with statistical significance(P<0.05).②Comparison between groups:There was significant statistical difference between the two groups before and after treatment(P<0.01).2.Comparison of renal function:After treatment,the serum creatinine and glomerular filtration rate in the Western medicine group remained stable,with no statistical significance(P>0.05).Western medicine group after treatment serum creatinine increased glomerular filtration rate decreased significantly,the difference was statistically significant(P<0.05).Compared with the Western medicine group,the Western medicine group was significantly better than the Western medicine group(P<0.05).3.Comparison of nutritional status:Western medicine group before and after treatment,red blood cell count,hemoglobin,plasma albumin were increased,the difference was statistically significant(P<0.05).Western medicine group of red blood cell count,plasma albumin decreased compared with the previous,hemoglobin increased,the difference was statistically significant(P<0.05).Compared with the Western medicine group,the treatment effect of the Western medicine group was superior to that of the Western medicine group(P<0.05).4.Comparison of serum potassium:Chinese and Western medicine group after treatment compared with before treatment,serum potassium increased significantly,or even hyperkalemia.The difference was statistically significant(P<0.05).Western medicine group after treatment,serum potassium increased,but in the normal range.The difference was statistically significant(P<0.05).There was no significant difference between the two groups(P>0.05).5.The occurrence of end events:56 cases were enrolled in the Chinese and Western medicine groups,15 cases occurred in the end point event,26.78%in the Western medicine group,53 cases occurred in the Western medicine group,35 cases occurred in the end point event and 60.34 in the end point event%.Using Kaplan-Meier analysis,the results showed that the overall survival rate of Chinese and Western medicine group was significantly higher than the Western medicine group.6.End-point Cox regression analysis results:water and electrolyte imbalance,nutritional status and different treatment options are risk factors for end point events.Electrolyte disorders are associated with a 10.074-fold risk of end point events in patients with non-electrolyte imbalance;patients with low plasma albumin have a 0.289-fold risk of end-point events in patients with high plasma albumin.Western medicine treatment of patients with end point risk is 4.256 times the treatment of traditional Chinese and Western medicine.In conclusionFirst:chronic renal failure with aging,occult onset characteristics,mostly middle-aged women,the primary disease mainly by chronic glomerulonephritis,hypertensive nephropathy,gout nephropathy.Second:The treatment of spleen and kidney can significantly improve the patient’s symptom score,so that renal function in a certain period of time to maintain stability,delay renal failure,and to improve the patient’s nutritional status also have significant results.Third:water and electrolyte disorders,nutritional status and different treatment options are risk factors for CRF endpoints.The treatment of spleen and kidney can improve the survival rate of patients,postpone patients into dialysis time.Fourth:CKD5(non-dialysis)patients present the existence of metabolic disorders,while traditional Chinese medicine contains a high amount of potassium ions,so the clinical use of Chinese medicine treatment should be closely monitored electrolyte.