Treatment Of Diabetic Nephropathy By Wang Shaokui 's "Qingre Liangxue" Method And Its Experience

Background:Diabetic kidney disease (DKD) is one of the most common complications of diabetes, and also is a major cause of end-stage kidney disease. Epidemiological survey found that the incidence of DKD showed an increasing trend.However, Western medicine for the treatment of DKD is relatively limited. It is still an urgent need to solve the problem how to prevent the occurrence and development of DKD effectively. In recent years, Chinese medicine has made some progress in preventing the occurrence and development of DKD effectively, and initially shows its unique advantages. Previous studies have shown that DKD has a pathogenesis feature of the blood heat, but now the associated research is still a bit less.Studing classic books and combining with his clinical experience for many years extensively, Professor Wang Bao-kui put forward that the blood heat is the basic pathogenesis feature of DKD, and that the heat-clearing and blood-cooling is the basic treatment method of DKD, and achieved a certain clinical effect. Currently the research for Professor Wang Bao-kui’s method of the heat-clearing and blood-cooling and his laws of prescription is still lacking.Objects:Using statistical methods, we discussed Professor Wang Bao-kui’s laws of prescription based on the heat-clearing and blood-cooling method, and summarized Professor Baokui Wang’s experience in treatment of DKD systematically and comprehensively, in order to promote using experience for clinical practice.Methods:Based on real-world approach, cored to clinical outpatient, this study recorded the whole process of treatment, collected those cases, and collated, tracked, completed them. Then we standardized those cases, fill in the report form, for statistical analysis. We analyzed patients’ general information, main symptoms, treatment efficacy, and prescriptions. In this paper, logistic regression, Wilcoxon rank test, Chi-square test, t test and other statistical methods for data processing and analysis were applied.Results:①Fatigue, increased nocturia, edema, Increased urinary bubble, Insomnia, blurred vision, dry stool, Waist and knee’s pain, dry mouth and throat, and numbness are the main symptoms of the DKD. We compared different stages of the main symptoms of DKD, and found that nocturia have differences.② Depending on the different efficacy evaluation and stages, we counted them respectively that, the efficacy of DKD stage Ⅲ’s patients was that the kidney assays evaluation:the total effective rate was 100%; the blood glucose evaluation (exclude patients whose blood glucose was well under control before the treatment):the total effective rate was 60%; the main symptoms integral evaluation (exclude patients who didn’t have main symptoms):the total effective rate was 50%. The efficacy of the DKD stage IV’s patients was that the kidney assays evaluation:the total effective rate was 82.86%; the blood glucose evaluation (exclude patients whose blood glucose was well under control before the treatment):the total effective rate was 78.57%; the main symptoms integral evaluation (exclude patients who didn’t have main symptoms):the total effective rate was 71.88%. The efficacy of the overall situation was that the kidney assays evaluation:the total effective rate was 88.10%; the blood glucose evaluation (exclude patients whose blood glucose was well under control before the treatment):the total effective rate was 71.05%; the main symptoms integral evaluation (exclude patients who didn’t have main symptoms):the total effective rate was 68.42%.③The frequency of the DKD of the stage III, the top 10 ranked herbs were coptis, kudzu, radix trichosanthis, caulis sinomenii, burned atractylodes macrocephala, medlar, atractylodes lances, pollen typhae, scutellaria, rehmannia glutinosa. The frequency of the DKD of the stage Ⅳ, the top 10 ranked herbs were kudzu, coptis, caulis sinomenii, atractylodes lances, pollen typhae, rehmannia glutinosa, medlar, radix trichosanthis, burned atractylodes macrocephala, scutellaria.㏕he statistics of different doses for different symptoms, kudzu, caulis Sinomen Ⅱ, burned atractylodes macrocephala, rehmannia glutinosa showed significantly different among different urinary protein groups of DKD stage Ⅲ; kudzu, coptis, caulis Sinomenii, medlar, scutellaria showed significantly different among different urinary protein groups of DKD stage Ⅳ. The statistics of different doses for whether patients eat cold things, kudzu, coptis, caulis Sinomenii, rehmannia glutinosa, medlar, radix trichosanthis, burned atractylodes macrocephala, atractylodes lances showed significantly different. The statistics of different doses for different BMI of patients, pollen typhae, rehmannia glutinosa, radix trichosanthis, burned atractylodes macrocephala showed significantly different.Conclusions:①Professor Wang Bao-kui treat patients of DKD with the heat-clearing and blood-cooling method. The clinical efficacy is very significant.② Using real-world approach, we can get the basic prescription based on the heat-clearing and blood-cooling method, which is basically same with the prescription Professor Wang Bao-kui commonly uses in clinical.It reflects the basic idea of the heat-clearing and blood-cooling method, and it can be for clinical reference.③ There is a certain regularity that Professor Wang Bao-kui uses different doses of drugs according to different symptoms. There is certain correlation between different doses and different urinary protein and whether patients eat cold things.