Clinical Study On Differentiation Of Traditional Chinese Medicine Syndrome In Patients With Diabetic Nephropathy

BackgroundDiabetic nephropathy(DN) is one of the most common complication of diabetes, the pathology of glomerular capillary pathological changes to mainly lesions.The cause of DN includes:genetie、metabolie、lifestyle and other factors. There is no effective prevention methods with DN at present, but in the treatment of diabetic nephropathy in recent years has accumulated a weathlth of experience in the clinical therapy of them and shows a unique advantage.Object ivesThis research focuses on the patient’s major existing symptoms, syndrome points type characteristics and the correlation with relevant lab, then provides foundation of syndrome for Chinese medicine dialectical differentiation, makes Chinese medicine more useful for extending life for the diabetes nephrosis patient, improves their quality of life, provides powerful medical foundation to promote their social regression and provides a new breakthrough for the study on TCM treatment of diabetic nephropathy.MethodsThe research takes the diabetic nephropathsis patients of Guangdong traditional Chinese medicine hospital as the research object and uses cross-sectional survey in experimental design.201cases were incorporated into effective cases. Refer to the DN syndrome diagnostic standard and symptoms grading quantitative table of the Chinese herbal medicine clinical research guiding principle promulgated by the state drug administration in2002and the diagnosis, differentiation classification and curative effect evaluation standard association of Chinese medicine of Diabetic nephropathy and the TCM prevention guide of the diabetic nephropathy which promulgated by the Association of Chinese medicine in2007, set quantitative syndromes questionnaire. The generally material is needed too, including the patient’s generally (gender, age etc.), and the patient’s laboratory related material (such as Glu、HbAlc、Scr、24hUAE). The collected data is established to a database by the SPSS17.0statistical software for analysis. Statistical methods:Measurement data is presented by x士s, while counting material using X2and Kruskal-Wallis inspection. The differences have statistical significance (P<0.05).Result1.The diabetes nephrosis patient demographics mainly in middle-aged and old people is given priority to, but no significant differences between men and women.2. In cases with deficiency syndrome undertaking diabetes nephrosis, weakness(80.1%), dry mouth and throat (41.3%), anorexia (40.3%), soreness of loins and knees(29.4%), Eat less poor appetite (24.9%), ack of words and being discouraged(22.9%)were the most common deficiency syndromes. In cases with Sthenic Syndrome undertaking iabetes nephrosis, limb numbness (46.8%), dropsy (44.8%) were the most common Sthenic syndromes. Lake light tongue, white-greasy fur, Slippery-stringy pulse, deep-pulse were the most common tongue and pulse manifestation. Deficiency of the both qi and yin was the most common deficiency syndrome (54.73%), followed by both spleen and kidney (30.35%), Spleen and Kidney Yang Deficiency (6.97%), liver-kidney yin deficiency (4.97%), and the deficiency of yin and yang (2.98%)3. In cases with pathogenic factors prevailing undertaking this measure, blood stasis inside was the most common excess syndrome(38.8%), followed by phlegm and stasis(29.343%), dampness turbidity(5.97%), dampness heat (3.99%). Most patients have intermingled deficiency and excess with158cases(68.11%).4. TCM syndrome type and the diabetes nephrosis clinical analysis is related. There is no obeious difference between deficiency of the both qi and yin and clinical stages. The most common syndrome of distibutiong with DN5and DN4is deficiency of both spleen and kidney, spleen and Kidney Yang Deficiency,the results are statistically significant(P<0.05). The differences of HbAlc and Scr in five TCM syndrome types has statisitics significance(P<0.05). The difference of NO in three teams has statisitics significance(P<0.05). The difference of ET in three teams has statisitics significance(P<0.05).5. The diabetes nephrosis patients’gender, age,24hUAE,24hmAlb was not statistically significant with the distribution of syndromes(P>0.05).ConclusionThe research point out the deficiency of spleen and kidney is the main mechanisms in diabetes nephrosis patients。Deficiency of the both qi and yin and blood stasis are the most common deficiency syndromes. The differences of HbAlc and Scr in five TCM syndrome types has statisitics significance. The difference of NO in three teams has statisitics significance. The difference of ET in three teams has statisitics significance.Diabetes nephrosis patients’gender, age,24hUAE,24hmAlb was not relativity significant with the distribution of syndromes.