Observe The Curative Effect Of Tonifying And Clearing Kidney,Regulating Collateral And Eliminating Turbidity In Treating 5-stage Chronic Kidney Disease(Non-dialysis)

My supervisor,Professor.Sun Wei,has abundant clinical experience in chronic kidney disease(CKD)treatment,and persists in researching and studying relevant literatures at all times and in all over the world for years.By combining his long-term clinical practice with his good understanding of medical knowledge,Sun recognizes that the patients of chronic kidney disease needs to initiate TCM treatment in the very beginning of the disease onset in order to prolong disease progression,and points out that the basic mechanism of chronic kidney disease belongs to kidney deficiency and damp turbidity(phlegm).Sun creats the therapeutic principle of tonifying and clearing kidney,and regulating collateral and eliminating turbidity,and includes effective prescription in treating chronic renal failure,which is recognized by peer colleagues and patients for the significant curative effect in clinical application.Objective:To observe the curative effect of tonifying and clearing kidney,regulating collateral and eliminating turbidity in treating 5-stage chronic kidney disease(non-dialysis).method:A total of 30 5-staeg CKD(non-dialysis)patients at nephrology department in Jiangsu province hospital of TCM(2014.09-2014.12)were recruited in this study.All included patients were provided Western basic treatment and TCM treatment(tonifying and clearing kidney,regulating collateral and eliminating turbidity).Follow-up visits were conducted respectively on 0m,3m,6m,9m and 12m after medication,and relevant laboratory indicators(urea nitrogen,creatinine,eGFR,hemoglobin,albumin,carbon dioxide combining power,serum patassium)were re-examined and recorded.Survival quality questionnaires were filled in,then the changes in this statistics were set as self-control for statistical analysis and clinical effectiveness evaluation,especially in renal function,dialysis indication,adverse event or serious adverse event.In the end,the curative effect of tonifying and clearing kidney,regulating collateral and eliminating turbidity on treatment 5-stage CKD was assessed.Time-point tables of follow-up visit were delivered to the patients for storage.If the patient was not able to reach the endpoint in the 1 st year,then the same treatment was about to implement before the follow-up visit in the next year.The observation duration of this clinical trial was one-year.result:For 30 included cases,a total of 28 cases were selected for the final analysis after excluding 1 case of losing follow-up and 1 case of reaching dialysis end.1.Urea nitrogen in all patients reduced gradually after treatment,and significant difference was found between results of 12m after treatment and before treatment(p<0.05);2.Serum level of creatine was elevated in patients 3m after treatment,serum creatine levels of 6m,9m and 12m after treatment were reduced,statistical significance was found between results of 12m after treatment and before treatment(p<0.05);3.eGFR level was elevated 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);4.Hb level was elevated 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);5.Albumin level was elevated 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);6.The change in serum potassium during treatment was not significant.The serum level of patassium was reduced 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);7.The change in carbon dioxide combining power during treatment was not significant.Carbon dioxide combining power was elevated 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);8.Survival quality of patients was elevated 12m after treatment,and statistical significance was found comparing to the result before treatment(p<0.05);9.Hyperkalemia with no palpitation or chest distress was found in 1 case 4w after medication,and the patient recovered after symptomatic treatment by re-examination.There was no case report of death,infection,heart and cerebral disorders or other adverse events.No significant abnormal results was found in blood routine(WBC differential counting and platelet counting),urine routine,stool routine with occult blood testing and ECG before and after treatment in all included subjects.Conclusion:1.In the 5-stage of chronic kidney disease(CKD).the nitrogen metabolites excreting function of kidney reduced,interior accumulation of dampness and turbid lowered renal function.Tonifying and clearing kidney,regulating collateral and eliminating turbidity had favorable curative effect,which increased nitrogen metabolites excretion,reduced renal burden,elevated eGFR,protected remnant kidney function and prolonged the further deterioration of renal function.2.Due to long disease course,complicate clinical symptom and massive mental stress and economic pressure,the survival quality among 5-stage CKD patients were poor.Tonifying and clearing kidney,regulating collateral and eliminating turbidity was able to improve the survival quality of those patients;3.For 5-stage CKD patients,the application of tonifying and clearing kidney,regulating collateral and eliminating turbidity was safe and feasible after controlling of blood pressure,blood glucose,acidosis and electrolyte disturbance.However,other relevant laboratory indicators were needed to be closely observed.