Study On The Distribution Characteristics Of TCM Syndromes Of Proteinuria In Type 2 Diabetic Nephropathy

Diabetic kidney disease (DKD) is a microvascular complication of diabetes, generally refers to diabetic glomerular sclerosis, which has its specific clinical evolution procedure, the early stage is higher glomerular filtration rate, followed by emergence of microalbuminuria, urine albumin gradually increased and then stepped into clinical albuminuria stage, and finally led to renal failure. Proteinuria is an important indicator of diabetic nephropathy, related to the prognosis and progress of diabetic nephropathy, the progress of this disease can be effectively prevented in early proteinuria stage by strict control of blood sugar, blood pressure, blood fat, once the clinical proteinuria stage appears, indicating the accelerate of disease progression, the development could lead to end-stage renal failure. So control and reduce proteinuria become the top priority when slowing the progression of diabetic nephropathy, the Western medicine treatment of diabetic nephropathy proteinuria mainly take the strict control of blood pressure, blood sugar, blood fat, improve microcirculation of blood vessels as the main aspects of treatment, Chinese medicine is also an important means of treatment to control proteinuria, and delaying the progression of Diabetic kidney disease, if could improve the early stage microalbuminuria and delaying clinical albuminuria stage, there is great clinical value for Chinese medicine.Objective:This study is under the guidance of Chinese medicine theory, attempt to research from the perspective of proteinuria, preliminary discuss the early stage Diabetic kidney disease microalbuminuria and distribution characteristics of syndromes of clinical proteinuria stage, provide more reliable basis for the further treatment of Diabetic kidney disease proteinuria.The paper includes in two parts:literature review and clinical research. Literature review has two sections, the first section is the Western medicine review summary, which summarizes the diabetic nephropathy-related factors, in order to further the development of better prevention of Diabetic kidney disease proteinuria. The second section is the Chinese medicine review summary, summarizes naming and classification of the diabetic nephropathy proteinuria under Chinese medicine, etiology, pathogenesis, the syndrome differentiation and treatment, and so on.Research Method:In clinical research part, conduct survey and research for 120 patients in our hospital who has diagnosed as diabetic nephropathy proteinuria, according to Mogensen staging criteria, patients were divided into two groups Group A and Group B, Group A select stage III of microalbuminuria (24-hour urine albumin quantitatively between 30mg-300mg), group B Stage IV of clinical proteinuria (24-hour urine albumin quantitatively between 0.5g-3.5g), referring to diagnostic criteria in 《Standardization of diabetic nephropathy for traditional chinese medicine research and treatment program))issued in the year 2012, develop questionnaires to collect information on Chinese medicine clinical symptoms and signs, perform frequency statistics and cluster analysis based on the collected data.Results:In the group of Diabetic kidney disease early stage proteinuria(Group A), the main deficiency syndrome is spleen qi deficiency and kidney essence deficiency, the main sufficiency syndrome is blood stasis, dampness syndrome. Compared with the group of Diabetic kidney disease early stage proteinuria(Group A), the deficiency syndrome for clinical proteinuria stage group(Group B) sees more spleen qi deficiency and kidney essence deficiency, but kidney essence deficiency syndromeis more prominent; the sufficiency syndrome is also empirical blood stasis, dampness syndrome, but the blood stasis symptoms show a higher frequency of occurrence, the extent of blood stasis heavier.Conclusion:The Chinese medicine syndrome characteristics for Diabetic kidney disease proteinuria is deficiency in origin and enrichment in symptom, early stage proteinuria and clinical albuminuria stage have a common pathogenesis, which spleen qi deficiency, kidney essence deficiency, blood stasis, dampness syndrome, but the degree of severity are different, a larger number of patients with more prominent kidney essence proteinuria, blood stasis syndrome in clinical albuminuria stage,which may associated with long illness from the spleen to kidney, chronic illness into the meridians.