Based On The Theory Of Collaterals Disease To Investigate The Observation On The Clinical Efficacy Of Modified Shenluotong In Diabetic Nephropathy Of Stage ?

Objective:By observing the curative effect of modified Shenluotong to diabetic nephropathy of stage ? with syndrom of spleen-kidney deficiency and blood stasis,from the collaterals disease theory to investigate the diabetic nephropathy,to investigate the therapeutic effect of modified Shenluotong treating ? stage of diabetic nephropathy,and provide some theory basis for Chinese medicine treatment of diabetic nephropathy.Methods: Choice Hebei Provinsial TCM Hospital of nephrology inpatient and the outpatient cases of diabetic nephropathy eligible for selected.62 diabetic nephropathy of stage ? with syndrom of spleen-kidney deficiency and blood stasis were randomly divided into two groups,32 cases were in the treated group,30 cases in the control group.The treatment course of two groups is 3 months.Two groups of patients were given same basic therapy,adjust the way of life,control diet,control blood glucose,blood pressure and blood lipid.The control group added piperazine ferulate dispersible tablets,the treated group added modified Shenluotong.Observe the curative effect of TCM Syndrome,the clinical curative effect of disease in both group and changes of TCM symptomatic integral before and after treatment,Observe in two groups before treatment and 1 month after treatment and 3 months after treatment the change of fasting plasma glucose(FPG),2 hour postprandia blood glucose(2hPG),glycosylated hemoglobin(HbA1c),cholesterol(CHOL),triglyceride(TG),low ensity lipoprotein(LDL-C),blood urea nitrogen(BUN),Serum reatinine(Scr),blood ?2-microglobulin(?2-MG),urine ?2-MG,glomerular filtration rate(GFR),24-hour urinary total protein(UTP),endohtelin-l(ET-l),plasminogen activator inhibitor-1(PAI-1).With SPSS21.0statistical software for statistical analysis,and evaluate the efficacy.Results:1 After treatment,TCM symptomatic integral of two groups decreased significantly(P<0.01),the treated group was better than the control group,the difference was statistically significant(P<0.01).2 The comparsion of curative effect of TCM symptoms between two groups: after the treatment,the total effective rate of the treated group was83.33%,the total effective rate of the control group was 53.33%,the treated group was better than the control group,the difference was statistically significant(P<0.05).3 Comparsion of curative effect of disease between two groups:after treatment,the total effective rate of treated group was 90%,the total effective rate of the control group was 60%,the treated group was better than the control group,the difference was statistically significant(P<0.01).4 1 month after treatment,FPG,2hPG,HbA1 c of two groups compared with before treatment,the difference was statistically significant(P<0.01 or P<0.05),the difference of HbA1 c between two groups was not statistically significant(P>0.05),the treated group was better than the control group in decreasing the levels of FPG,2hPG(P<0.05).3 months after treatment,FPG,2hPG,HbA1 c of two groups compared with before treatment,the difference was statistically significant(P<0.01),the difference of FPG,2hPG,HbA1 c between two groups was statistically significant(P<0.05).5 1 month after treatment,CHOL,TG,LDL-C of two groups compared with before treatment,the difference was statistically significant(P<0.01 or P<0.05),treated group was better than the control group in decreasing the levels of CHOL,LDL-C(P<0.05),the difference of TG between two groups was not statistically significant(P>0.05).3 month after treatment,CHOL,TG,LDL-C of two groups compared with before treatment,the difference was statistically significant(P<0.01),the treated group was better than the control group in decreasing the levels of CHOL,TG(P<0.05),the treated group was better than the control group in decreasing the level of LDL-C(P<0.01).6 1 month after treatment,BUN,Scr,blood ?2-MG,urine ?2-MG of twogroups and GFR of treated group compared with before treatment,the difference was statistically significant(P<0.01 or P<0.05);GFR of control group compared with before treatment,the difference was not statistically significant(P<0.05);treated group was better than the control group in decreasing the level of Scr,BUN,blood ?2-MG,urine ?2-MG,improving the level of GFR(P<0.05).3 months after treatment,BUN,Scr,blood ?2-MG,urine ?2-MG,GFR of two groups compared with before treatment,the difference was statistically significant(P<0.01),the treated group was better than the control group in improving the level of GFR(P<0.05),the treated group was better than the control group in decreasing the levels of BUN,Scr,blood ?2-MG,urine ?2-MG(P<0.01).7 After treatment for 1 month and for 3 months,UTP of two groups decreased significantly(P<0.01),the treated group was better than the control group,the difference was statistically significant(P<0.01 or P<0.05).8 After treatment for 1 month,PAI-1,ET-1of two groups decreased significantly(P<0.05),the difference of PAI-1,ET-1 between two groups was not statistically significant(P>0.05).After treatment for 3 months,PAI-1,ET-1of two groups decreased significantly(P<0.01),the treated group was better than the control group,the difference was statistically significant(P<0.05).Conclusions:1 Modified Shenluotong can significantly improve the symptoms and signs of the diabetic nephropathy and significantly improve the clinical efficacy.2 Modified Shenluotong can significantly reduce the urinary protein,improve the disorders of glucose metabolism,improve the disorders of lipid metabolism,can decrease the levels of BUN,Scr,blood ?2-MG,urine ?2-MG,improve the level of GFR,protect the renal function.3 Modified Shenluotong can decrease the levels of PAI-1,ET-1,which can low down the progress of renal fibrosis,delay the development of diabetic nephropathy.