Meta-analysis And Clinical Study On The Treatment Of Stage Ⅲ-Ⅳ Diabetic Nephropathy With The Method Of Strengthening Kidney And Reducing Turbidit

Objective:This study aims to evaluate the clinical efficacy and safety of the method of reinforcing the kidney and down bearing the turbid therapy combined with ACEI/ARB medicine in treating DKD stage 3/4.The first study uses meta-analysis to provide evidence-based medicine evidence for the clinical treatment of DKD,while the second study is a retrospective study to investigate the treatment effect of reinforcing the kidney and down bearing the turbid therapy combined with conventional western medicine therapy for DKD stage 3/4.Methods:The first study retrieved clinical randomized controlled trials from databases including CNKI,Sino-Med,VIP,Wanfang,PubMed,Cochrane Library,and Web of Science,up to July 2022.Two researchers assessed the selection and the risk of bias according to pre-established criteria,and verified the data from the final included studies through meta-analysis.The second study was a retrospective study of patients with DKD stage 3/4 treated with the method of reinforcing the kidney and down bearing the turbid therapy combined with conventional western medicine.Patients were selected from the Beijing Hospital of Traditional Chinese Medicine,Beijing University of Chinese Medicine Dongfang Hospital,and the First Affiliated Hospital of Zhengzhou University.Both groups underwent treatment for no less than 12 weeks,and data analysis of TCM syndrome integration,biochemical index changes,and clinical treatment response rate were performed using SPSS26.0 software.Results:The first study selected 12 clinical randomized controlled trials and included 1659 subjects for meta-analysis.The meta-analysis showed that the observation group with ACEI/ARB drugs was better than the control group in 24hUTP,BUN,UAER,HbA1c,and clinical efficiency in DKD stage 3/4,with fewer adverse events and high clinical safety.The second study enrolled 140 patients with DKD stage 3/4,with 70 patients in the control group and 70 patients in the observation group.The observation group was better than the control group in terms of reducing TCM syndrome score,24hUTP,BUN,HbAlc,lipid index,as well as maintaining Scr level and improving eGFR level.The difference between the outcome indicators was statistically significant(P<0.05).Conclusion:The first study suggests that reinforcing the kidney and down bearing the turbid therapy combined with ACEI/ARB medicine is better than conventional western therapy in maintaining serum biochemical indicator levels for DKD patients.With high safety evaluation,it can effectively improve clinical efficiency and provide evidence-based support for DKD treatment.The second study suggested that the therapy of reinforcing the kidney and down bearing the turbid therapy combined with ACEI/ARB medicine in the treatment could effectively improve the TCM syndromes of patients with DKD stage 3/4,increase the clinical effective rate,reduce proteinuria,and slow down the progress of the disease.The clinical application is worth considering.