The Clinical Study Of CKD3-4 About TCM Syndrome Type Distribution And Efficacy Based On Real World

Objective: explore the distribution of CKD 3-4 period and the curative effect of clinical medication in the real world.Methods: In accordance with the inclusion criteria and exclusion criteria,220 cases of CKD3-4 patients according to the real situation of clinical practice of non medication were randomly divided into traditional Chinese medicine and Proprietary Chinese Medicine plus basic treatment group,traditional Chinese medicine plus basic treatment group,Proprietary Chinese Medicine plus basic treatment group,traditional Chinese medicine and Proprietary Chinese Medicine group,traditional Chinese medicine group,Proprietary Chinese Medicine group,western medicine group,which in turn corresponds to A group and B group,C group,D group,E group,F group and G group.When the group according to TCM syndrome diagnosis standard of differentiation,it was every 12 weeks for CKD3 patients to monitor urea nitrogen,serum creatinine,glomerular filtration rate,and was every 8 weeks for CKD4 patients.The score of TCM syndrome was compared at 24 weeks before and after treatment,and the urea nitrogen,serum creatinine and glomerular filtration rate were compared between 0 weeks and 24 weeks after treatment.Results:(1)220 cases of CKD3-4 patients,deficiencyof Qi of the spleen deficiency,a total of 123 cases(55.9%);followed by spleen kidney yang deficiency syndrome in 53 cases(24.1%);17 cases of liver kidney yin deficiency syndrome(7.7%);lung and kidney deficiency syndrome and QiYin deficiency syndrome with two less,were 16 cases and 11 cases(7.3%)(5%);both positive were 163 cases(74.1%),of which 83 cases of blood stasis syndrome,(50.9%);in the wet muddy syndrome in 48 cases(29.5%);32cases of damp heat syndrome(19.6%);The distribution of deficiency syndrome in stage CKD3 and CKD4 was different(P<0.05),and the proportion of spleen qi deficiency syndrome in CKD4 phase was lower than that in CKD3 phase,and the proportion of spleen kidney yang deficiency syndrome was higher than that of CKD3 phase;(2)TCM syndrome integral comparison: A group,B group and C group compared with before treatment,the symptom score was significantly decreased(P<0.05);after treatment,comparison between groups,A group and B group had no significant difference(P>0.05);A group and B group in improving the symptom scores were significantly better than C group(P<0.05);clinical efficacy analysis: group A total efficiency of 86.21%,the total efficiency of group B 86.74% C group,the total efficiency of 78.33%,compared with A group and B group had no significant difference(P>0.05);there was significant difference between A group and C group(P<0.05);there was statistically significant difference B group and C group(P<0.05);A group and B group in the clinical curative effect was significantly better than group C(P<0.05).(3)A group,B group and C group after treatment can effectively increase the eGFR,decrease the level of Scr(P<0.05);no statistical significance in A group and B group after group eGFR,the level of Scr(P>0.05);A group and B group in the increase of eGFR and decrease the level of Scr were betterthan group C(P<0.05);A group,B group,BUN level of C group compared with before treatment was not statistically significant(P>0.05).Conclusion :1.CKD3-4 patients with this syndrome to the most common spleen and kidney qi,more than the certificate to the majority of blood stasis syndrome.With CKD3 progress to CKD4 period,spleen and kidney qi deficiency has developed the trend of spleen and kidney yang.2.Traditional Chinese medicine and Proprietary Chinese Medicine plus basic treatment group,traditional Chinese medicine plus basic treatment group were superior to Proprietary Chinese Medicine plus basic treatment in improving the clinical symptoms of patients.3.Proprietary Chinese Medicine plus basic treatment group and traditional Chinese medicine plus basic treatment group can effectively increase eGFR and reduce Scr level.