Clinical Study Of Tonifying Kidney And Clearing Damp-heat, Activating Blood And Removing Turbidity Toxin Therapy On Delaying Progression Of Chronic Kidney Disease Of Stage 5

Objective:To evaluate the effect of tonifying kidney and clearing damp-heat, activating blood and removing turbidity toxin Therapy for delaying the progression of chronic kidney disease (CKD) of stage 5. Improve the Traditional Chinese Medicine (TCM) theory on CKD and establish novel TCM diagnosis and therapy methods.Methods:60 patients with CKD5 were enrolled in this study. All the patients received western medicine plus TCM "tonifying kidney and clearing damp-heat, activating blood and removing turbidity toxin Therapy " treatment for 12 months. All the data, including clinical symptoms, kidney function, calcium phosphorus metabolism, lipid metabolism, nutritional status and safety indicators, were collected every 4 months. These data were subjected to statistical analysis of and assessment of TCM clinical outcome.Result:1. Clinical symptom:The total score of clinical symptoms of 60 patients decreased continuously compared with the initial level every 4 months. And the clinical symptom score in 8th month was significantly reduced statistically compared with 0 month (P< 0.05), the clinical symptom scores in 12th month had significant statistical difference compared with 0 month (P< 0.01). There was a significant difference between 12th month integral and 0 month in principal syndrome "complexion dark and gloomy, lassitude, soreness and weakness of waist and knees and body weight are drowsy, anorexia, dry mouth" (P< 0.01).2. Syndrome therapeutic effect:After treatment for 12 months, the clinical symptom score of 58 patients was decreased, the total effective rate was 81.7%.3. Disease curative effect:After 12 months of treatment, among the total 60 cases,2 cases were markedly effective (3.3%),31 cases were effective (51.7%),16 cases were stable (26.7%),11 cases were ineffective (18.3%). The total effective stability rate was 81.7% and the total effective rate was 55%.4. Renal function:The serum creatinine (Scr) of 60 patients gradually decreased every 4 month compared with initial level. And there was a significant reduction in Scr between 4th month and 0 month (P< 0.01). Furthermore, Scr of these patients in 8th month were also decreased (P< 0.05) compared with 0 months. The glomerular filtration rate (GFR) of 60 patients showed an increasing trend compared with 0 month according to the data from the every 4 months. And there were notably improvements in GFR in the 4th and 8th month compared with 0 month separately (P< 0.05).5. Calcium and phosphorus metabolism:The blood phosphorus and PTH of 60 cases in the treatment group decreased slightly and statistically after 12 months compared 0 month with.6. Lipid metabolism:The total cholesterol (TC), triglyceride (TG) and low-density lipid (LDL) in 60 cases were decreased slightly and statistically in 12 months compared with 0 month (P< 0.05).7. Nutritional status:The hemoglobin of 60 patients in 12 months showed an improving trend compared to initial level and the difference was statistically significant (P< 0.05).8. Safety index:In the whole treatment period, there were 3 cases of hyperkalemia. Bur after the treatment the level of serum potassium was reduced.60 cases in the course of treatment did not change the color of stool. The stool frequency and quality was changed only in 2 patients. No other side effects were appeared in 60 patients.Conclusion:Tonifying kidney and clearing damp-heat, activating blood and removing turbidity toxin Therapy can improve the clinical symptoms, especially in the main symptoms. In the short term (4-8 months), it can delay the progression of chronic renal disease. And it can delay the progression of chronic renal disease (CKD5) in forward. It has a certain regulation of calcium and phosphorus metabolism, adjusting the lipid metabolism, attenuating anemia and improving renal function.