| Objective:To observe the effect of chinese medicine on the levels of urinary albumin in Chronic Glomerulonephritis and to provide the basis for evidence-based medicine.Method:From September2011to January2012, we had a randomized controlled clinical research to40patients with proteinuria of Chronic Glomerulonephritis. Forty patients were blocking assigned randomly to two groups, thirty patients in the experimental group and ten in the control group. According to TCM syndromes of the patients, who they could be divided into five parts, deficiency of both qi and yin, deficiency of both qi and yang, blood-stasis, damp-heat and water-dampness. Chinese medicine was given additionally to patients in the experimental group combined with routine treatment, taken in two times per day(granular formulation).The control group took Losartan Tablet50mg, once daily. The treatment course for both groups was eight weeks. The laboratory index and scores of TCM syndromes were observed at0,4th,8thweeks.Result:1. Among the40CGN patients, main syndrome with both Qi and Yin Deficiency (33) account for82.5%; both Qi and Yang Deficiency (7) account for17.5%; secondary syndrome with damp-heat (23) account for57.5%; blood-stasis (12) account for30%; water-dampness (5) account for12.5%.Patients are often together with1-2TCM syndrome.2. After4weeks treatment, the24h proteinuria of both two groups weren’t reduced compared with that before treatment and there is no statistics significance(P>0.05);however, at the8th week, the24h proteinuria of both two groups all drop compared with that before treatment and there is statistics significance(P<0.05);the drop of proteinuria of experimental group after treatment is more obvious, and there is statistics significance compared with the difference of control group(P<0.05).3. After4weeks treatment, both of the two groups of UmAlb/Cr are decreased comparing with0week (P<0.05); after8weeks treatment, the decline is more obvious(P<0.05);At the4th and8th week, there is no significant difference between experimental and control groups(P>0.05).4. At the8th week, ALB of experimental group is significantly higher than before the treatment(P<0.05);but control group is no significant difference comparing with0weeks(P>0.05).After therapy, there is significant difference between experimental and control group(P<0.01).5. At each visit viewpoint,(32-MG comparison between the two groups were not significant differences(P>0.05).6. At each visit viewpoint, eGFR comparison between the two groups were not significant differences(P>0.05).7. At each visit viewpoint, Scr, BUN, UA comparison between the two groups were not significant differences(P>0.05).8. After8weeks treatment, the Cys-C of both two groups all drop compared with that before treatment (P<0.05), but there is no statistics significance compared with the difference of control group (P>0.05).9. At the8th week, Scores of TCM syndromes of experimental groups is significantly decreased comparing with0week(P<0.01);After therapy, there is significant difference between experimental and control groups(P<0.01).10.After8weeks treatment, the experimental group and control group in the efficacy of Chinese medicine did not reach clinical remission, significant effective rate were16.67%and0%，effective rate were50.0%and20.0%,total effective rate were66.67%and20.0%. The differences were significant (P<0.01). The Research shows that the experimental group can improve syndrome better than the control group.11. After8weeks treatment, the experimental group and control group in the clinical remission of Western medicine were26.67%and10%. Significant effective rate were26.67%and10%,effective rate were6.67%and20.0%,total effective rate were60%and20%. The differences were significant (P<0.05). The Research shows that the experimental group can improve Western medicine better than the control group.Conclusion:1.Chinese medicine participate in treatment the CGN (CKD1-2) proteinuria treatment can improve patients’ clinical symptoms.2.Chinese medicine can decrease the24h urinary protein and urine microalbuminuria, increase the level of ALB,but have no effect to urine β2-MG.3.To the early renal dysfunction patients (CKD1-2), Chinese medicine can reduce the Cys-C, and maintain GFR stability.4.The inadequacies of this article are two points:①the clinical observation time is short, the long-term outcome could not be verified in the traditional Chinese medicine.②only some patients had renal biopsy,we won’t predicate the therapeutic effect from pathological perspective systematic. |
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