The Clinical Effect Of Tonifying Qi,Nourishing Yin And Dissolving Blood Stasis Method In The Treatment Of Early Stage Diabetic Nephropathy

Objective:Understand and explain the etiology,diagnostic methods and treatments of early stage diabetic nephropathy(DN)from the perspective of traditional Chinese medicine(TCM).Formulate the theory and treatment method for early stage DN diagnosed as qi yin deficiency combine with blood stasis.Investigate the efficacy and safety of combining tonifying qi,nourishing yin and dissolving blood stasis method with western medicine to treat early stage DN.With the comparison of western medicine alone,the efficacy of tonifying qi,nourishing yin and dissolving blood stasis method was observed and the safety of TCM herbs used in treating early stage DN was documented for the reference in clinical usage.Methods:60 patients with diagnosis of early stage DN withqi yin deficiency combine with blood stasis were randomized divided into two groups(30 patients each).The control group was given oral gliquidonee 30mg tid,acarbose 50mg tid and irbesartan150mg sid.Besides the basic treatment,the treatment group was given tonifyingqi,nourishing yin and dissolving stasis formula one dose(200ml)divided into two times a day.The two groups were treated with a course of 3months.The clinical efficacy,syndrome score of TCM,blood glucose,HbAlc.blood pressure,blood lipids,UACR,UTP.SCr,CysC,were observed and comparedResults:?The total effective rate in the control groupwas 66.67%but in the treatment group was 93.33%;the treatment group had better efficacy compared tothe control group(P<0.05).After treatment,the syndrome score of TCM in the bothgroups decreased compared with before treatment(P<0.05).When compared with the control groupthe clinical signs of lethargy,edema,lower back pain,turbid urine,heatiness in the center of palm and feet,low fever in the afternoon,dry mouth had improved in the treatment group(P<0.05).?The total effective rate of reduce blood glucose was 96.67%in the treatment group,and 73.33%in the control group;the efficacy of reduce blood glucose level was better in the treatment group.?The total effective rate of reduce blood pressure was 93.33%in the treatment group,and 80.00%in the control group;the efficacy of reduce blood pressure was better in the treatment group.?After treatment,the levels of TC,TGand LDL-C were decreased significantly and the level of HDL-C was increased significantly(P<0.05 or P<0.01).On the other hand,the level of TC decreased significantly and the level of HDL-C increased significantly(P<0.05),but the difference of the level TG and LDL-C were not significant.?After treatment,the levels of UACR and UTP were decreased in both groups compared with before treatment(P<0.01),between two groups the treatment group was significantly lower than the control group(P<0.05).?After treatment,the levels of SCr and CysC were decreased in both groups(P<0.05 or P<0.01),between two groups only the level of CysC in the treatment group was significantly lower than the control group(P<0.05).Conclusions:Tonifying qi,nourishing yin and dissolving blood stasis formula combined with western medicine can help to reduce UACR and improve kidney functions.Hematology,urinalysis and liver functions were carried out before and after treatment in both groups and not showed any abnormality and no clinical complication during treatment period.The tonifying qi,nourishing yin and dissolving blood stasis method used in treating early stage DN had significant effect to improve clinical signs,reduced blood glucose,reduced blood pressure,reduced blood lipids,reduced urine albumin,improved kidney function,delay the progression of DN and safe.