| Objective:To observe the clinical efficacy and safety of Nourishing Yin,clearing heat and removing blood stasis in the treatment of early stage of diabetic nephropathy.Methods:According to the diagnostic criteria of early type 2 diabetic nephropathy and TCM syndrome of yin deficiency and stasis heat,60 patients who met the inclusion criteria were randomly divided into control group(n=30)and treatment group(n=30).The control group was treated with basic western medicine,and the treatment group was treated with Erdi Weimao decoction,2 doses a day,1 dose in the morning and evening,and observed for 12 weeks.Before and after treatment,the scores of TCM symptoms and signs,blood pressure,blood glucose,blood lipid,urinary albumin/creatinine,urinary protein,serum creatinine and cystatin C,inflammatory factors(TGF-β1,IL-6,TNF-α),hemorheology(whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity)were recorded,and the efficacy and safety were evaluated.Results:There was no significant difference in age,sex and course of disease between the two groups before treatment(P>0.05).There was balance between the two groups and the results were comparable.① curative effect of disease:the total effective rate of the treatment group was 96.67%.The total effective rate of the control group was 76.67%%.There was significant difference in the total effective rate between the two groups(P<0.05).② improvement of symptoms and signs:the improvement effect of dry mouth and thirst,sore waist and legs,low back pain such as prickles,frequent urination,edema and night sweats in the treatment group was better than that in the control group,and the difference was statistically significant(P<0.05).③ hypoglycemia:fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin decreased significantly in both groups after treatment(P<0.01),and the curative effect of the treatment group was better than that of the control group(P<0.05).④effect of reducing urinary protein:the ratio of urinary Microalbumin to urinary creatinine and 24-hour urinary protein in the two groups after treatment were significantly lower than those before treatment(P<0.01),and the treatment group was superior to the control group(P<0.05).⑤ effect of improving renal function:serum creatinine and cystatin C were significantly improved in both groups after treatment(P<0.05 or P<0.01),and better in the treatment group(P<0.05).⑥ antihypertensive effect:SBP and DBP in both groups decreased significantly after treatment(P<0.01).⑦Lipid-regulating effect:the levels of TC,TG,LDL-C in both groups after treatment decreased(P<0.01),and HDL-C increased in both groups after treatment(P<0.05),and the lipid-lowering effect in the treatment group was better than that in the control group(P<0.05).⑧changes of hemorheology:the plasma viscosity and the whole blood high and low shear viscosity scores of the treatment group were improved after treatment(P<0.05),and the treatment group was superior to the control group(P<0.05).⑨Anti-inflammatory effect:the scores of TGF-β1,IL-6 and TNF-α in the two groups decreased significantly after treatment(P<0.05),and the anti-inflammatory effect in the treatment group was better than that in the control group(P<0.05).⑩ the safety evaluation indexes were in the normal range,and no adverse reactions occurred in the process of observation.Conclusion:It is suggested that erdiwayu decoction combined with conventional western medicine is better than western medicine alone in the treatment of early stage of diabetic nephropathy.ErDiWeiMao decoction can not only improve the clinical symptoms of patients with early diabetic nephropathy,reduce urine protein,blood sugar,blood pressure,regulate blood lipid,improve the state of blood hypercoagulability,protect renal function,delay the progress of diabetic nephropathy.It is safe and effective,which is worth further study. |
