A Retrospective Analysis Of 21 Cases Of Clinical Proteinuria Stage In Diabetic Kidney Disease And The Elementary Analysis Of The "State-Target-Cause-Result" Academic Thought Of Professor Xiaolin Tong

It is traced the origin of traditional Chinese medicine in the diagnosis and trea tment of diabetic kidney disease in the part of literature study of this research and discussed the nomenclature, syndrome differerations and mechanism of DK D in traditional Chinese Medicine. In the clinical study part, it is a retrospecti ve study on the clinical research of traditional Chinese medicine in the long-ter m treatment of DK.D.21 cases with 1-4years of treatment has been screened an d recorded the clinical information on their first time, one year later, one and a half year later, the second year, the third year and the fourth year, A total o f 69 visits.Objective:1.To estimate the efficacy of symptoms of TCM and test indicators of traditional Chinese medicine in the long-term treatment of DKD in the clini cal proteinuria stage.2.To summarize the disciplinarian of the main symptoms a nd tongue and pulse characteristics.3.To summarize the clinical experience of P rofessor Xiaolin Tong in the treatment of this disease.4. To try the research pa ttern of the old Chinese medicine academic experience mining and the academi c thought summary from the methodology study.Methods:Screening qualified cases, coding a case report form, Extracting rese arch data, establishing ele-database by Epidata3.1, dealing data with frequency distribution statistics test, t-test, regression curve analysis and other statistical m ethods to process data and draw charts.Results:1.The main symptoms are weak breath and fatigue, numbness of limbs, insomn ia, blurred vision, frequent nocturia, edema, waist ache, astriction, itchy skin ul cer and Chills. The efficacy of the main symptoms is perfect and the best effe ctive rate is 90%.2.The common tongue is dark red, plump with yellow and greasy fur and Blo od Stasis in Sublingual Vessels. Thread, wiry, rapid and weak pulses are the m ain ones.3. Inspection indicators:The average reduction of 24h urinary protein after one year, the one and a half year,two years treatment are 0.66g95%CI (-0.95,-0.4 1),1.00g95%CI (-1.67,-0.38), 1.11g95%Cl (-1.79,-0.57).The average redu ction of TG are 0.39mmol/L95%CI (-1.06,-0.12),1.55 mmol/L95%CI (-2.31,-0.82),1.09 mmol/L95%CI (-1.92,-0.22). The differences have statistical sign ificance.The average of reduction of BUN after one year treatment is 39.1mmo 1/L95%CI (-88.5,-0.5).The average reduction of HbA1C%is 1%95%CI (-1. 97,-0.1).The differences above have statistical significance. The average redu ction of SBP after one year and two years treatment are9mmHg 95%C1 (-18,-2),13 mmHg95%CI (-27,-3). The other indexes such as GFR,Scr,BUN,DB P,CHO,HDL,LDL are not significantly different from baseline.3.The main medicines are Dahuang, Shuizhi powder,Danshen,Shengjiang,Huang lian,Jixueteng,Zhimu,Chishao,Guizhi,Jinyingzi,Sanqipowder,Fuling,Hongqu,Huangba i and Yinyanghuo.Among them,the 3 most commonly used drugs are Dahuang, Huangqi and Shuizhi. Frequences of use are 94.2%、92.8%and 89.9%。Conclusion:1 The effective rates of main symptoms are perfect with the treatment of TC M.2. TCM has a therapeutic effect in reducing 24h urinary protein and slowing d own the decrease of GFR and the increase of Scr, BUN and reducing SBP an d DBP,CHO.TG,HDL and HbA1C.3.Dahuang,Huangqi and Shuizhi powder are the main drugs in the therapy for this disease.Dahuang+Huangqi+Shuizhi powder+Danshen is the core co mpatibility and may be the target medicines for DKD.In theoretical summary s ection,taking DKD as an example and citing a tipical case.it is discussed the "state-target-cause-result"’academic thought of Professor Xiaolin Tong by intro duce the different states, targets, causes and results of DKD.