Clinical Observation On Treatmenting Patients With Stage 4 Chronic Kidney Disease According To The Academic Ideology Of Professor Wang Lixin

BackgroundIn 2001, American kidney foundation (AFK) firstly proposed the concept of chronic kidney disease (CKD). Despite the cause, as long as there is a renal damage or kidney function decline, with duration over 3 month can be diagnosed as CKD, within which kidney damage is define as kidney or dysfunction of the structure, with or without the accompany of GFR reduction. Syndrome with one of the following:pathologic abnormalities:blood or urine composition abnormal or radiological examination abnormity; Kidney function decline under 60ml/min, with or without an accompany of kidney damage. Base on the clinical manifestations severity and whether there are complications and influence of the prognosis of chronic kidney disease (CKD) divided into 5 stage. CKD4 is the stage with GFR15~29/min, it's uremia prophase change, this stage show with slow and progressive development, it's crucial beginning for the uremia period and inevitable stage. Current modern medical treatment therapy is focus in primary disease, lipid, step-down, diet control methods, yet in China, we combining traditional Chinese and western medicine treatment of domestic achieved more progress in delaying renal failure, improve the clinical symptoms has good curative effect.Chronic kidney disease 4(CKD4) mainly belong to ancient Chinese medicine "edema","addicted to poison","GuanGe" and "virtual fatigue" category. The pathogenesis is intricate, includes both the loss of vital "Qi" and pathogens aggregates of resistance and reality, thus define as mix of virtual reality weaken core and the proof of inclusion. Professor Wang Lixin's treatment for CKD patients define in Chinese medicine spleen and kidney Yang, turbidity poison, wet poison blood stasis applying "Wenyang detoxification huoxue" method treatment, preliminary achieved good results. Therefore, for clinical validation and scientific evaluation "detoxification huoxue" treatments for spleen and kidney Yang, turbidity poison CKD4 period of patients with blood stasis, this study was to collect 30 cases of spleen and kidney Yang, blood stasis CKD4 period wet poison before and after, using self-reflection patients of the study methods of observation, discuss the clinical curative effect.ObjectiveObservation of "Wenyang detoxification huoxue" treatment to CKD4 period patients with clinical curative effect, mainly including the clinical symptom, signs and laboratory index of the improvement.MethodsChoose Guangdong hospital of traditional Chinese medicine, hospital or clinic conform to the CKD4 period for diagnostic criteria and spleen and kidney Yang syndrome (hot) stasis wet chaotic block 30 patients, apply western medicine routine therapy (quality low-protein diet, step-down blood pressure, sugar, lipid-lowering, adjust the water, electrolyte and acid-base disorders, etc.) at the same time, combine Chinese medicine to give wenyang detoxification huoxue method treatment, in 2 months period of treatment. By contrast, their observed before and after treatment before the after the clinical symptoms, signs, hemoglobin Hb, liver function (blood of total protein Tp, albumin ALB), kidney estimated glomerular filtration rate (eGFR, creatinine (Scr), plasma lipids (total cholesterol TC, triglyceride TG, low density lipoprotein LDL cholesterol, high-density lipoprotein (HDL), electrolyte calcium ion Ca, phosphorus ionp), parathyroid hormone PTH.Results1. Treatment effectivenessAmong 30 patients, the effective rate after treatment is 90% in general stability, general effective rate 73.3%. Within which with obvious improvement 10 cases (33.3%), with improvement 12 cases (40.0%), stable in 5 cases (16.7%), invalid three patients (6.7%).2. Treatment symptom analysis 30 patients TCM with 0 cases (0%),3 patients'clinical symptoms were obviously improved, (10%), with effective improvement 24 cases, (80%), and 3 invalid cases (10%). The static figure in comparison of the before and after treatment is meaningful with (P<0.01). Patients with lassitude, lack of Qi and no desire to speak, cold limb & waist, aversion to cold, nausea, lost of appetite, lumbar debility, wan abdominal distension full, epigastria distension and depression, body exhaustion, urine at night is long yet less, numbness basic disappearance, the difference was statistically significant(P <0.01). Vomiting, retention of fluid inside the body symptom improvement, (P<0.05). dry mouth, and tasteless mouth, less urine and in dark yellow color symptom showed no obvious improvement. (P>0.05)3. Laboratory index analysisCompare the before and after treatment figure, Scar reduce (P<0.05), eGFR rise (P<0.01). and it's effective, with TC, TG, LDL are relatively lower than before treatment (P<0.05), HDL saw no change significantly (P >0.05), TP, Hb increased (P<0.05). ALB, Ca,P no change (P>0.05). PTH reduces (P<0.05).4. Safety performance analysesOut of the total 30 patients after treatment only 2 shown with increased potassium which were return to normal after take Chinese traditional medicine and no further potassium rise, all others have no significant changes before and after the treatment potassium. None has abnormal bleeding pee.ConclusionUse "Wenyang detoxification huoxue " in CKD4 period, spleen and kidney Yang treatment of patients with wet chaotic stasis resistance, can better improve the clinical symptoms and reduce serum creatinine, improve the glomerular filtration rate, improve the lipid metabolism, improve nutrition, effectively delaying the progress of chronic renal failure.