| Objective To explore the clinical efficacy and safety of invigorating spleen and invigorating kidney and removing phlegm and detoxification to treat chronic kidney disease in 3 and 4 stages.Methods Analysis of references and related books,to combine traditional Chinese and western medicine treatment of chronic kidney disease(CKD)3,4 issue of the meta analysis,combined with retrospective analysis between September 2014 and December 2014,in the cooperation of Chinese and western medicine,southern medical university hospital,98 cases of CKD3,4 patients,and summary of Chinese and western medicine treatment,combined disease and TCM syndrome differentiation treatment reagent for multicenter,randomized,double-blind,controlled clinical trials,according to the random interval random method,and the proportion of 2:1,experimental group 40 cases,control group 20 cases.Both the experimental ogroup and the controlgroup received the basic treatment of western medicine.Meamvhile,the experimental group gave the invigorating and invioorating kidney to remove the phlegm and detoxify the turbidity granules,and the control group was given a placebo for 24 weeks.The pilot scheme was approved by the ethics committee of the centres.Recorded before and after treatment in patients with general clinical data,eGFR,serum creatinine(Scr),24 hours urinary protein quantitative(24 hupr),blood urea nitrogen(BUN),urinary inhibition C(CysC)(propagated),blood routine,blood Albumin[white blood cells(WBC),red blood cell(RBC),hemoglobin(Hb)and platelets(PLT)],TCM syndrome integral,and security index[side effects and adverse reactions,end point events,security check index],use SPSS20 statistical software for statistical analysis.Results In this clinical trial,60 cases were studied,50 cases were completed(36 in the experimental group,14 in the control group),10 were shed(4 in the test group and 6 in the control group).There were multiple follow-up records of shedding cases,and the results of the last primary efficacy index were transferred to the final result for statistical analysis.The results indicated that:1,eGFR and 24hUpr were used as the evaluation criteria for efficacy:7 cases were alleviated in the experimental group,18 cases were effective,10 were effective,5 were ineffective,and the effective rate was 87.5%.In the control group,3 cases were alleviated,4 cases were developed,6 were effective,7 were ineffective,and the effective rate was 65.0%.The difference was statistically significant(P<0.05).2.Compared with traditional Chinese medicine,there were 8 cases of clinical relief in the experimental group,18 cases showed effect,11 cases were effective,3 cases were ineffective,and the effective rate was 92.5%.In the control group,2 cases were alleviated,5 cases were developed,7 were effective,6 were ineffective,and the effective rate was 70.0%.The difference was statistically significant(P<0.05).3.Comparison of laboratory indicators:before the treatment of 24hUpr in the experimental group(2.54 + 0.64),the treatment was(1.58 + 0.59).In the control group,24hUpr was treated before treatment(2.62 + 0.77)and after treatment(1.96 + 0.65).After treatment,24hUpr decreased compared with the control group,and the difference was statistically significant(P<0.05).Before the treatment of Scr in the experimental group(239.25+ 70.80),the treatment was(178.18 + 62.97).The control group was(240.87 + 55.43)before treatment,followed by(223.63 +81.97).The Scr after treatment was lower than the control group,and the difference was statistically significant(P<0.05).Before the treatment,the treatment was(12.69+ + 2.96),followed by the treatment(11.05,plus or minus 3.20).The control group was(13.43 + 2.58)before treatment,followed by(13.75 + 4.68).After treatment,the BUN was lower than the control group,and the difference was statistically significant(P<0.05).Before the treatment of CysC in the experimental group(3.81 + + 2.67),the treatment was(1.63 + 1.90).The treatment of CysC in the control group was(3.99 +1.54)before treatment(2.87 + 1.61).After treatment,the CysC was lower than the control group,and the difference was statistically significant(P<0.05).Prior to treatment of eGFR(30.43 + 9.68),the treatment was(40.98 + 7.39).The control group was treated with eGFR before treatment(26.55 + 7.38),followed by(36.99 +6.58).The eGFR level was higher in the experimental group after treatment than the control group,and the difference was statistically significant(P<0.05).Conclusion Combined treatment of traditional Chinese and western medicine can effectively improve the clinical efficacy of chronic kidney disease,stage3-4,improve clinical symptoms and improve the quality of life of patients. |
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