| Purpose:To explore the TCM syndrome characteristics of patients with diabetes kidney disease(DKD)with damp heat syndrome of spleen stagnation,provide TCM syndrome evidence for the TCM syndrome differentiation of DKD.To observe the clinical effect of heat clearing and damp-removing Chinese herbal compound on DKD patients with damp-heat syndrome of spleen entrapment,and evaluate the clinical value of heat clearing and damp-removing Chinese herbal compound on DKD patients with damp-heat syndrome of spleen entrapment.Material and method:Using the method of cross-sectional study,280 patients with diabetes nephropathy who met the diagnostic criteria for diabetes nephropathy were collected from the endocrine ward of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.After the review of the researchers and supervisors,the subjects were those who were divided into the syndrome of dampness heat trapping spleen,and the baseline data and Mogensen、GFR、UACR stages of the patients with dampness heat trapping spleen were observed,Statistics were made on the distribution of symptoms and signs related to the TCM syndromes of the patients with diabetes kidney disease with damp heat trapping spleen syndrome,and the concurrent syndrome,to summarize the TCM syndrome characteristics of diabetes kidney disease with damp heat trapping spleen syndrome.61 patients who met the diagnostic criteria of diabetes kidney disease and the syndrome of dampness heat trapping spleen in traditional Chinese medicine were grouped according to the patient treatment plan.Those who did not use traditional Chinese medicine intervention were the control group,and those who used traditional Chinese medicine intervention were the observation group.On the basis of the conventional symptomatic treatment,the traditional Chinese medicine compound for clearing heat and removing dampness was added for treatment.The course of treatment of both groups was 60 days.The TCM syndrome scores,blood sugar,blood lipid Compare the effectiveness results of traditional Chinese medicine syndrome efficacy evaluation and clinical efficacy evaluation between the two groups of patients after treatment,including renal function,liver function,uric acid,etc.Results:A total of 280 patients were included in the study,of which 61 belonged to the syndrome of dampness heat trapping spleen,accounting for 21.78%.The Mogensen staging of patients with dampness heat spleen syndrome included 55 cases in stage III,and 6 cases in stage IV;The GFR grading of patients with dampness heat spleen syndrome is as follows: G2 in 8 cases,G3 a in 13 cases,G3 b in 37 cases,and G4 in 3 cases;The albuminuria grade of patients with damp heat syndrome was A1 in 10 cases,A2 in 45 cases,and A3 in 6 cases.In the damp heat spleen trapping group,there were 38 males and 23 females,with an average age of(61.45 ±12.54)years.There were 43 patients with a family history of diabetes,42 patients with hypertension.The duration of diabetes was(16.29 ± 4.20)years,and the average BMI was(24.85 ± 3.35)years;In the non damp heat spleen trapping group,there were 130 males and89 females,with an average age of(63.19 ± 11.96)years.There were 142 patients with a family history of diabetes,126 patients with hypertension.The duration of diabetes was(15.53 ± 5.00)years,and the average BMI was(22.18 ± 3.26)years.56 cases(91.80%)of DKD patients with the syndrome of damp-heat entrapment of spleen with red tongue;53cases(86.89%)had severe limb distress;50 cases(81.97%)were less angry and lazy;49cases(80.33%)had yellow and greasy fur;There were 48 cases of loose stool,accounting for78.69%;48 cases(78.69%)had pulse confucianism;46 cases(75.41%)had abdominal distension;39 cases(63.93%)suffered from nausea and stupor;35 cases had yellow urine,accounting for 57.38%;33 cases(54.10%)had sweating fever;32 cases(52.46%)suffered from nausea and stupor;There were 30 cases of skin itching,accounting for 49.18%;28 cases were hot,accounting for 45.90%;27 cases(44.26%)were sticky in the mouth;23 cases(37.70%)had yellow complexion;Thirty-three cases(54.10%)were thirsty and did not drink much.50 cases(81.97%)of DKD patients with damp-heat trapping spleen and deficiency of entrapped qi;10 cases(16.39%)were complicated with blood deficiency syndrome;29 cases(47.54%)were complicated with yin deficiency syndrome;43 cases(70.49%)were complicated with deficiency of yang;29 cases(47.54%)had kidney yin deficiency;45 cases(73.77%)had kidney yang deficiency;38 cases(62.30%)were complicated with spleen deficiency;41 cases(67.21%)had spleen yang deficiency;35 cases(57.38%)were complicated with blood stasis;24 cases(39.34%)were complicated with turbid poison.The baseline data of DKD patients in the observation group and the control group,such as gender,age,family history of diabetes,hypertension,course of diabetes and BMI,were comparable(P>0.05).There was no statistical difference between the observation group and the control group in the scores of various TCM syndromes related to damp-heat entrapment of spleen syndrome,such as abdominal distension,nausea,anorexia,loose stool,etc.before treatment(P>0.05);After treatment,the scores of TCM syndromes related to damp-heat syndrome of spleen entrapment in the observation group and the control group were significantly lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).There was no significant difference between the observation group and the control group in blood glucose,blood lipids and other test results before treatment(P>0.05);After treatment,the blood glucose(FBG,Hb A1c),blood lipid(TG,CHOL)test results in the observation group and the control group decreased significantly compared with those before treatment,and the blood glucose(FBG,Hb A1c),blood lipid(TG,CHOL)test results in the observation group were lower than those in the control group(P<0.05).There was no significant difference between the observation group and the control group in renal function and other related test results before treatment(P>0.05);After treatment,the renal function and other related results in the observation group and the control group were significantly improved compared with those before treatment,and the improvement of renal function and other related results in the observation group was better than that in the control group(P<0.05).The effective rate of TCM syndrome efficacy judgment and clinical efficacy judgment in the observation group was higher than that in the control group,with statistical difference(P<0.05).Conclusion:1.The syndrome of dampness heat trapping spleen in DKD patients accounts for about1/5 of the total population,with the majority of patients in Mogensen stage III,G3 b grade and A2 albuminuria.The TCM syndrome characteristics of DKD patients with dampness heat trapping spleen syndrome are mainly red tongue,heavy limb distress,lack of qi and lazy speech,yellow and greasy fur,loose stool,number of meridians and abdominal fullness.DKD patients with dampness heat and spleen entrapment syndrome are mainly characterized by qi deficiency,kidney yang deficiency,yang deficiency,spleen qi deficiency,and spleen yang deficiency.2.The application of heat-clearing and damp-removing herbs can play a better role in the treatment of DKD patients with damp-heat entrapment syndrome,and can improve various symptoms such as abdominal distension,nausea,anorexia,loose stool and so on,which have a certain regulatory effect on blood glucose,blood lipids and renal function. |
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