| Objective:To observe the clinical efficacy of Modified Shenqi Dihuang Decoction on type2 diabetic nephropathy(DN)patients with deficiency of both qi and yin and blood stasis and its influence on TCM syndrome,and to provide new treatment methods and ideas for clinical prevention and treatment of DN.Materials and Methods : The clinical data of patients with diabetic nephropathy diagnosed by Western medicine in the outpatient or inpatient department of nephrology in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September2019 to October 2021 were collected,and the data of patients meeting the inclusion criteria were collected.The selected patients were naturally grouped according to the treatment plan.The treatment included healthy lifestyle guidance,blood glucose and blood lipid control.The control group was treated with valsartan capsules of ARB drugs to control blood pressure.On the basis of the control group,the observation group was added with Jiawei Shenqi Dihuang Decoction,which was orally taken three times a day.After eight weeks of treatment,the changes of TCM syndrome score,laboratory physical and chemical indexes(24 h urinary protein quantification,serum creatinine,urea nitrogen,glomerular filtration rate,triglyceride,cholesterol,low density lipoprotein,glycosylated hemoglobin)in the two groups before and after treatment were observed.The data were analyzed by SPSS24.0 statistical software,and the efficacy of Modified Shenqi Dihuang Decoction was evaluated according to the TCM syndrome efficacy and clinical efficacy standards.Results:1.General information : A total of 59 cases were included in this study,including 33 cases in the observation group,18 males and 15 females,with an average age of 58.121 ± 7.607 years,8 cases in stage A2 and 25 cases in stage A3;t2DM duration of10.212 ± 3.595 years,blood pressure144.455 ± 3.898 / 88.303 ± 4.496 mmhg,BMI24.598 ± 2.818 kg / m2.26 cases in the control group,12 males and 14 females,with an average age of 57.077 ± 7.904 years old,6cases in stage A2 and 20 cases in stage A3;t2DM duration10.269 ± 3.650 years,blood pressure143.923 ± 4.069 / 87.731 ± 5.489 mmhg,BMI25.285 ± 2.497 kg / m2.There was no significant difference in gender,stage,course of disease,age,blood pressure and BMI between the two groups(P > 0.05).2.Comparison of TCM syndrome scores : both groups improved after treatment(P < 0.05);the improvement of TCM syndrome score in the observation group was more significant than that in the control group(P < 0.05).The total effective rate in the observation group was90.91 %,which was higher than 57.69 % in the control group(P < 0.05).In the comparison of single TCM syndrome scores,the single TCM syndrome scores of fatigue,shortness of breath and laziness,hand-foot-heart-heat,and limb pain in the two groups were improved(P< 0.05),and the single TCM syndrome scores of dry mouth and pharynx,and trouble and insomnia in the observation group were also improved(P < 0.05).Compared with the control group,the observation group had better effect on single TCM syndromes of fatigue and limb numbness(P < 0.05).3.Clinical efficacy comparison : the total effective rate of the observation group was 93.94 %,which was higher than 65.38 % of the control group(P < 0.05).4.Comparison of the main observation indexes UTP : After treatment,the two groups were improved compared with those before treatment(P < 0.05),and the effect of reducing UTP in the observation group was better than that in the control group(P < 0.05).5.Secondary observation indicators TG,TC,LDL-C,Hb A1 C,UREA,CREA,e GFR comparison : After treatment,the two groups compared with the previous physical and chemical indicators were improved(P < 0.05);compared with the control group,the physicochemical indexes of UTP,LDL-C,Hb A1 C,CREA and e GFR in the observation group were better improved(P < 0.05).Conclusion:The results of this study showed that Modified Shenqi Dihuang Decoction could treat type 2 diabetic nephropathy(stage A2 – A3)with deficiency of both qi and yin and blood stasis syndrome by supplementing qi and nourishing yin,activating blood circulation and dredging meridians,and removing blood stasis and dredging collaterals.It could significantly improve the TCM symptoms of patients with fatigue,shortness of qi and laziness of speech,dry mouth and pharynx,frequent urination,fever of hands and feet,trouble and insomnia,and limb pain.And effectively reduce 24 h urine protein,reduce kidney damage;help reduce blood lipids,glycosylated hemoglobin,improve glucose and lipid metabolism disorders;while reducing serum creatinine,it improves glomerular filtration rate,delays glomerular sclerosis,effectively protects renal function,and achieves good clinical efficacy. |
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