Based On Expert Questionnaires Of Diabetic Nephropathy "disease, Syndrome, Symptoms Associated With" Type And The Classification

Research backgroudDiabetic Nephropathy has been a predominant cause of ESRD (end-stage renal disease)accompanying by the increasing morbility of Diabetes mellitus, so some efficient measures should be taken to preclude such a progress. Nowadays, It is no denying the fact that a hot debate on the methods combing TCM and modern medicine, pathologies about DN or urine protein of DN during the nephrology academic community of traditional Chinese medicine. Therefore, It is essential for us to conform our cognition on the pathology of DN in the mechanism of TCM and dealing with the relationships between disease and syndrome or pattern of syndrome.Research methodsDuring the first trimester we collected materials and designed the questionnaire, then we compiled the questionnaire by mailing to hospitals affiliated to several universities of TCM or chief physicians of nephrology in3Grade A hospitals, utilized the China Nephrology Institute of Traditional Chinese and Western Medicine in the2011annual symposium National Congress to interview experts who joined in this conference.Research ContentsReorganizing ancient medical books on the basis of syndromes such as po-lydipsia, polyphagia, dieresis, foamy urine,edema, oliguria, soreness of waist, dim-sighted, and so forth, we referred meanwhile to ancient documents from the library and database of Beijing University of Chinese medicine to sort out the pattern models and pathologies of DN.Additionally,searching CNKI Wanfang database and VIP database to analyse the modern TCM doctors’un-derstandings on above statements.Additionally, we called together the director of nephrology department and endocrinology department of hospitals affiliated to Beijing University of Chinese Medicine to draft the associated quest ionnaire on relationships between disease and syndrome or pattern of syndrome.The questionnaire includes37clinical questions.After reclaiming these ques-tionnaires,we regularly logged the data into a spreadsheet using a piece of Epidata software. To guarantee the facticity of da taentering, allquestionnaires are keyed in twice by two persons following by the test of consistency as well as random data sampling at a10percent to insure the authenticity.Research resultsWe reclaimed55pieces comprised by35three A grade hospitals and2second A grade hospitals from66pieces sending out, of which2questionnaires are incomplete and3questionnaires were excluded for the lack of right filling. There are47professors or chief physicians in the55pieces.As a result,78percent of the experts believe that the DN should be named shen disease of xiaoke disease.On the topic of relationships between disease and syndrome or pattern of syndrome,most of the experts think deficiency of both qi and yin takes a fundamental role and phlegm and blood stasis trans impedance plays an important role as well. Especial ly speaking, blood stasis plays a vital role on the progress of DN, which occupies68percent of referred experts.As to the treatment based on syndrome different iat ion of urine protein, TCM pathologies such as deficiency of Qi in middle-Jiao, kidney collateral stasis,disharmony between heart and kidney and essence from food flowing downward. As for the treatment for the DN,76percent experts insisted that treatment based on syndrome differentiation should be combined with Mogensen stages.Last but not least, when we using syndrome element pattern to cure DN,90percent experts considered that we should bear the syndrome element of blood stasis in mind.DiscussionOn the contrary to Western medicine, as based on mathematics thoughts and experience medicine, the advices accounts for a large proportion in the clinical decisions of TCM.So we reach a consensus on issues about pattern models of DN, methods to combine TCM and western medicine to cure DN, TCM pathology of DN and urine protein and syndrome element with the help of this research.Because experts’s advice is the lowest level of EBM(evidence based medicine), which refrains its clinical value,so we need to conduct a further investigation on the epidemic prevalence of DN on TCM semiotic symptomatology, What’s more,we need a large randomized controlled trial to verify the efficiency of TCM therapy based on patterns of syndrome acquired from this research.