Clinicai Observation Of Invigorating Spleen,warming Kidney And Clearing Collaterals In Treatment Of Deficiency Of Spleen And Kidney Qi (Yang) And Blood Stasis Syndrome In G1-3A3 Diabetic Nephropathy Prescription

Objective:To observe the clinical efficacy and safety of Jianpi Wenshen Tongluo Prescription in the treatment of spleen-kidney qi（Yang）deficiency and blood-stasis syndrome of G1-3A3 diabetic nephropathy,and to provide theoretical basis for the promotion of this recipe.Methods:In this study,60 diabetic nephropathy patients who met the inclusion and expulsion criteria were randomly divided into control group and treatment group（30 cases in each group）.The control group was treated with western medicine,and the treatment group was treated with Jianpi Wenshen Tongluo Prescription for 8 weeks.Record of two groups of patients before and after the treatment of TCM syndrome integral,fasting blood glucose,blood sugar 2 hours after meal,glycated hemoglobin,triglycerides,total cholesterol,low-density lipoprotein cholesterol,24-hour urinary protein quantity,serum creatinine,urine protein and urine trace albumin/uric creatinine quantitative,and glomerular filtration rate was calculated to evaluate the efficacy and safety.Results:Before treatment,there were no statistically significant differences in age,gender,symptoms and laboratory tests between the two groups（P>0.05）,indicating that the two groups were balanced and the results were comparable.（1）Disease efficacy:the total effective rate of the treatment group was 88.46%,the total effective rate of the control group was 64.29%,the total effective rate of the two groups was compared,P<0.05,there was a statistical difference.（2）Traditional Chinese medicine syndrome total points:the total effective rate of the treatment group was 88.46%,the total effective rate of the control group was 57.14%,the comparison of the total effective rate of the two groups,P<0.05,there was statistical difference.（3）The improvement of symptoms and signs:the treatment group was better than the control group in the improvement of waist and knee soreness,fatigue,abdominal distention,edema,dark complexion,irregular stool,nocturia and multiple symptoms,P<0.05,there was statistical difference.（4）Hypoglycemia:after treatment,fasting blood glucose,2 hours postprandial blood glucose and Hb A_1cin 2 groups were significantly improved compared with before treatment,P<0.05;There was no difference between treatment group and control group,P>0.05.（5）Lowering blood lipid:triglyceride,cholesterol and low density lipoprotein were all decreased in the two groups,P<0.05.The lipid-lowering advantage of the treatment group was better than the control group,P<0.05;（6）Reducing urinary protein:after treatment,the quantification of 24-hour urinary protein and the ratio of urinary microalbumin to urinary creatinine in 2 groups were significantly lower than before,P<0.05;The treatment group had an advantage over the control group,P<0.05.（7）Improved renal function:after treatment,serum creatinine and cystatin C were decreased,glomerular filtration rate was increased,P<0.05;The treatment group had better improvement effect,P<0.05.Safety evaluation:No adverse reactions occurred during the treatment.Conclusion:Based on the summary of the tutor’s rich clinical experience,this study applied the combination of invigorating spleen,warming kidney and tongluo prescription and western medicine basic treatment to treat DKD（G1-3A3 stage）patients with spleen-kidney Qi（Yang）deficiency and blood stasis syndrome,and the test results showed that:1.In terms of reducing urinary protein excretion in DKD patients,the combination of spleen-strengthening,kidney-warming and collator-clearing prescription with western medicine is superior to western medicine alone.2.The application of invigorating the spleen,warming the kidney and tongluo prescription combined with western medicine is superior to western medicine alone in reducing blood lipids.3.The combination of spleen strengthening,kidney warming and collatals decoction with western medicine is superior to western medicine alone in improving renal function and delaying the progression of DKD.4.The combination of spleen-strengthening,kidney-warming and collateral-clearing prescription with western medicine is superior to western medicine alone in improving clinical symptoms.