Clinical Observation Of Yishen Tongluo Fang Addition Or Subtraction Treatment Of Spleen And Kidney Deficiency CKD Patients With Wet Stasis Type Resistance In Stage3-4

Objective:To Explore the clinical efficacy of Yishen Tongluo Fang addition or subtraction treatment of spleen and kidney deficiency CKD patience with wet stasis type resistance in stage3-4, using the method of Yishen Tongluo Fang add or subtract to treat the spleen kidney deficiency CKD patients with wet stasis type resistance in stage3-4,and observing the change of a patient’s hemoglobin (HGB), blood urea nitrogen (BUN), serum creatinine (SCR), estimated glomerular filtration rate (eGFR), urinary albumin concentration(UAC),and the neutrophil gelatinases-associated lipocalin (NGAL).At the same time,detecting the change of the patients’cerebrovascular function, investigate the relationship between cerebrovascular function and renal function, and it is valuable in prevention of cerebrovascular disease.Methods:The 100 patients who meet the criteria were randomly divided into two group: treatment group (Yishen Tongluo Fang addition or subtraction combined western medicine foundation treatment) and control group(only western medicine foundation treatment),they are both 50 men.Giving the control group basic western medicine treatment such as control of blood pressure, blood sugar, blood fat.On other hand, on the basis of the western medicine treatment,the treatment group taking Yishen Tongluo Fang addition or subtraction for six months.Interval four weeks we check the patients’Routine blood, kidney function, etc. Before and after the cure,we both detected the patients’NGAL and cerebrovascular function,and also collected the clinical information before and after the treatment such as syndromes integral data, and using statistical principle to discuss the different cure effect in renal function, NGAL and the cerebrovascular function between treatment group and control group.Results:(1)①fter the treatment, the treatment group and control group’s HGB were improved (P<0.05) both,the HGB curative effect in both groups after treatment were almost the same, and has no statistically significant(P>0.05);②After the treatment, both of the groups’ patients’ level of BUN and SCR were drop, and eGFR increased significantly (P< 0.05), the result is the SCR decline degree and the eGFR increased degree,the treatment group is better than the control group (P<0.05), while BUN numerical comparison after treatment in both groups had no significant difference (P>0.05);③The Urinary albumin level,after treatment, the treatment group was obviously decreased (P<0.01), while the control group had no significant change (P> 0.05), the drop degree of the urinary albumin levels of the treatment group is better than control group (P< 0.05);④The NGAL levels after treatment, two groups of patients were decreased, but the treatment group decreased more when compare with control group, the difference has statistically significant (P< 0.05);⑤After the treatment, both groups’patients’cerebrovascular function score increased, the size of the treatment group increased slightly better than the control group, the difference has statistically significant (P< 0.05).(2)The CKD3-4 patients’ NGAL has positively correlated (P< 0.01) with BUN, SCR and UmAlb, and has negative correlation with eGFR (P< 0.01), and had nothing to do with HGB and cerebral function assessment points.(3)The CKD3-4 patients’Cerebrovascular function test results has negative correlated (P<0.01) with AGE,BUN, SCR and UmAlb, and has positively correlated with eGFR,but has no correlation with HGB,(4)The curative effect of treatment group and control group of TCM syndrome total effective rate was 86% and 52% respectively, there are differences between the two groups in overall curative effect,and through the rank and test analysis, has statistically significant difference (P< 0.01).(5)The total curative effective rate of the treatment group and control group were 80% and 64%, respectively, the overall efficacy of the two groups are differences, and has statistically significant difference (P< 0.05), the results indicate that the overall efficacy of treatment group was better than the control group.Conclusion:(1)The research results show that Yishen Tongluo Fang addition or subtraction combined with western medicine therapy,is superior to only take western medicine foundation treatment in reducing the SCR, UmAlb, NGAL and increase the eGFR, as well as to improve the level of cardiovascular function.(2)This topic shows that with the decrease of a patient’s renal function level, NGAL gradually rise, it remind that NGAL can indicate the progress of renal failure of a CKD patient.(3)This study indicates that with the decrease in the level of kidney function, cerebrovascular function decreased gradually, it is useful to use cerebrovascular function testing to monitor a patient’s accident risk who with chronic kidney disease (CKD) heart cerebrovascular.(4)Yishen Tongluo Fang has certain advantages in improving a patience’s overall clinical efficacy, and can enhance the patient’s clinical symptoms and signs, also the quality of life.