Clinical Application Of Chronic Diseases Management By Traditional Chinese Medicine In Non-dialysis Patients With Chronic Kidney Disease Stages 3-5

Objective:The purpose of this study is to evaluate the clinical efficacy of chronic kidney disease management in the treatment of chronic kidney disease stage 3-5 non-dialysis patients.Taking renal function and nutritional indicators,TCM syndrome score and quality of life as evaluation indicators,this study discusses the characteristic advantages of chronic kidney disease management in delaying the progress of chronic kidney disease in TCM,and provides a basis for clinical application.Methods:A total of 100 cases of CKD3-5 non-dialysis patients who met the inclusion criteria from March 2017 to September 2018 in the Department of Nephrology of Jiangsu Hospital of Traditional Chinese Medicine were collected and divided into experimental group and control group.In the course of observation,3 cases in the experimental group and 2 cases in the control group were closed due to poor compliance,0 cases in the experimental group and 3 cases in the control group were closed due to Renal replacement therapy.There were 47 cases in the final experimental group and 45 cases in the control group.There were 22 cases of chronic glomerulonephritis,10 cases of diabetic kidney disease,5 cases of hypertensive nephropathy,4 cases of uric acid nephropathy and 6 other cases in the experimental group,and 18 cases of chronic glomerulonephritis,13 cases of diabetic kidney disease,3 cases of hypertensive nephropathy,3 cases of uric acid nephropathy and 8 other cases in the control group.The control group received health Education,controlled blood pressure,blood sugar and blood lipid,corrected anemia and hypoproteinemia,and oral Chinese patent medicine and basic treatment of symptomatic treatment.The experimental group was included in the management of chronic diseases in traditional Chinese medicine on the basis of the control group.Totally 6 months of treatment were followed up.The changes of serum creatinine,blood urea nitrogen,serum uric acid,glomerular filtration rate.plasma albumin,TCM syndrome score and quality of life before and after treatment were compared between the experimental group and the control group.Results:1.Symptom effect:The total effective rate was 78.7%in the experimental group and 42.2%in the control group.The curative effect of syndrome in the experimental group,was better than that in the control group(P<0.01).1.1 Symptoms of TCM:In the experimental group,fatigue,weakness of waist and knee,lack of food,nausea and vomiting,edema and numbness of limbs can be significantly improved after treatment;In the control group,fatigue,lack of appetite,edema,nausea and vomiting and numbness of limbs can be significantly improved after treatment,but not significantly improve the weakness of waist and knee.Compared with the control group,the experimental group could improve the symptoms of fatigue,edema,nausea and vomiting,but had no obvious advantages in improving the symptoms of lumbar and knee weakness,eating less and inactivity,and limb numbness.1.2 Integral of TCM Syndrome:The total score of TCM symptoms in CKD3 group was not significantly different between experimental group and control group(P>0.05).The total score of TCM symptoms in CKD4 group was significantly different betvween experimental group and control group(P<0.05).The total score of TCM symptoms in CKD5 group was significantly different after treatment between experimental group and control group(P<0.01).It showed that with the progress of renal function,the experimental group had obvious advantages in improving TCM symptoms compared with the control group,Obvious.2.Clinical efficacy:The total effective rate of the experimental group was 85.1%and that of the control group was 60.0%.The clinical efficacy of the experimental group was better than that of the control group(P<0.05).2.1.Renal function:After treatment,the renal function of CKD3 experimental group was significantly improved,and that of the control group was more stable than that before treatment.The improvement of renal function of the experimental group was better than that of the control group after treatment.There were 6 patients in the experimental group who reversed to CKD1-2,14 patients who maintained in CKD3 and 0 patients who progressed to CKD4-5;2 patients in the control group who reversed to CKD1-2,16 patients who maintained stability,and 3 patients who progressed to CKD4-5.CKD4 experimental group maintained stable renal function after treatment;the control group improved renal function after treatment;the experimental group had significantly better renal function than the control group.There were 3 patients in the experimental group who reversed to CKD1-3,10 patients who maintained in CKD4 and 1 patient who progressed to CKD5,and 0 patients in the control group who reversed to CKD1-3,10 patients who maintained in CKD4 and 2 patients who progressed to CKD5.The renal function of CKD5 experimental group was stable after treatment,and the renal function of control group was significantly improved after treatment.The experimental group could delay the progress of renal function compared with the control group,and the experimental group reversed to CKD1-4 in 2 cases.The control group reversed to CKD1-4 in 1 case.2.2.Nutritional indicators:The nutritional indexes of CKD3,CKD4,CKD5 experimental group and control group were stable compared with before treatment(P>0.05);the nutritional indexes of CKD3 experimental group were improved compared with control group(P<0.05),and the nutritional indexes of CKD4 and CKD5 experimental group had no significant difference compared with control group(P>0.05).3.Quality of life:After treatment,the experimental group had significant effect on GH,VT,PF,RP,BP and SF,MH dimension was more effective before treatment,RE dimension had no obvious advantage before treatment;the control group had significant effect on BP dimension,GH,PF,RP,SF dimension was more effective before treatment,VT,RE,MH dimension had no obvious advantage compared with before treatment.Compared with the control group.the experimental group had significant effect in VT and RP dimension,obvious advantage in GH,SF and MH dimension,but no obvious advantage in PF,RE and BP dimension.Conclusion:1.The management of chronic diseases in TCM can effectively improve TCM syndromes.The symptoms of lumbar and knee weakness,nausea and vomiting,edema are more obvious than those in the control grou;2.The management of chronic diseases in TCM can significantly reverse CKD3 renal function,effectively delay the progress of CKD4 and CKD5 renal function,and maintain stable nutritional indicators;3.The management of chronic diseases in TCM can significantly improve the GH?VT?PF?RP?BP?SF?MH of CKD patients.The improvement of RE is not obvious compared with that before the management.Therefore.the adjustment of emotional therapy in TCM should be emphasized;4.The characteristics of TCM chronic disease management,such as high safety,light economic burden and significant improvement of patients' quality of life,are more suitable for the long-term management of chronic diseases,and there are no adverse events in the observation process.lt is worth further in-depth study and large-scale clinical promotion.