Clinical Study On Yishen Jianpi Tongluo Method In Treating Early Type 2 Diabetic Kidney Disease

Objective:By comparing the clinical efficacy of Yishen Jianpi Tongluo method and simple Yishen Jianpi method in the treatment of early type 2 diabetic kidney disease,verify the therapeutic advantages of Tongluo Method combined with disease and syndrome,and a new special treatment method was provided for the clinic.Methods:In this study,patients who were diagnosed as type 2 diabetic kidney disease with G2-G3 a syndrome were diagnosed as spleen and kidney deficiency patients in the outpatient department or ward of the Endocrinology Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.According to the principle of random grouping,it was divided into western medicine group,Yishen Jianpi group and Yishen Jianpi Tongluo group in 30 cases.The western medicine group received basic treatment,which included hypoglycemic,antihypertensive,lipid-lowering,etc.The Yishenjianpi group added traditional Chinese medicine decoction to the kidneys and spleen,and the Yishenjianpitongluo group was The kidney spleen group was combined with leech granules,and the medication time was 8 weeks.Observe and record the TCM syndrome score,glucose metabolism index(FBG,Hb A1c),blood pressure index(DBP,SBP),lipid metabolism index(CHO,TG,HDL-C,LDL-C),proteinuria-related indicators(24h-PRO,UACR),renal function-related indicators(e GFR)and other indicators,using SPSS 23.0 statistical data processing software for statistical analysis of the data.Result:1.Evaluation of the clinical efficacy of traditional Chinese medicineThe effective rate of the Yishen Jianpi Tongluo group was 83.3%,the effective rate of the Yishen Jianpi group was 73.3%,and the effective rate of the Western medicine group was20.0%.Both the Yishen Jianpi Tongluo group and the Yishen Jianpi group were better than Western medicine group.Yishen Jianpi Tongluo group and Yishen Jianpi group have similar efficacy.2.TCM symptom score improvement situationAfter treatment,the TCM syndrome scores of patients in Yishen Jianpi Tongluo group,Yishen Jianpi group and Western medicine group all decreased,and the symptoms and signs of Yishen Jianpi Tongluo group and Yishen Jianpi group improved significantly before and after treatment(P <0.01),there was no statistically significant difference in the degree of syndrome score reduction in the Western medicine group(P>0.05).At the same time,compared with the three groups after treatment,the total scores of TCM symptoms of patients in Yishen Jianpi Tongluo group and Yishen Jianpi group were significantly reduced,and the scores of the two groups were significantly lower than those of Western medicine group(P<0.01).In terms of the single clinical symptoms of traditional Chinese medicine,the Yishen jianpi tongluo group and the Yishen jianpi group have a good improvement effect.The characteristic symptoms of diabetic kidney disease such as oliguria or frequent urination,and blurred vision are more effective.The improvement effect of Yishen Jianpi group was obvious.3.Western medicine efficacy evaluationThe effective rate of Yishen Jianpi Tongluo group was 83.3%,the effective rate of Yishen Jianpi group was 80.0%,the effective rate of Western medicine group was 23.3%,and the efficacy of Yishen Jianpi Tongluo group and Yishen Jianpi group was better than Western medicine group,Yishen Jianpi Tongluo group and Yishen Jianpi group have similar efficacy.4.Indicators of e GFR and proteinuriaIn terms of e GFR,the Yishen Jianpi Tongluo group improved slightly(P<0.05),and there were differences between the three groups(P<0.05).In terms of proteinuria,compared with before and after treatment,the three groups of24h-PRO and UACR were significantly improved(P<0.05).Compared with the three groups,both the Yishen Jianpi Tongluo group and the Yishen Jianpi group were better than the Western medicine group(P<0.05),and only 24h-PRO between the Yishen Jianpi Tongluo group and the Yishen Jianpi group exists statistical differences(P<0.05).5.Indicators of lipid metabolismCompared with the three groups of patients before and after self-treatment,the TG andLDL of the four items of blood lipid were significantly improved(P<0.01),and the improvement of CHO and HDL-C in the Western medicine group was not obvious(P>0.05);the comparison between the groups of CHO and HDL-C,LDL-C have significant differences in efficacy(P<0.01),TG improvement effect is not significantly different(P>0.05).6.Blood pressure and blood sugarThe blood pressure and fasting blood glucose of the three groups before and after treatment and between the three groups were not statistically significant.Conclusion:The Chinese medicine effect of Yishen Jianpi Tongluo method and Yishen Jianpi method alone in treating G2-G3 a type 2 diabetic kidney disease is significant;it can improve urinary turbidity,oliguria or frequent urination,and blurred vision related to diabetic kidney disease.In terms of symptoms,and Tongluo method has the therapeutic advantage of combining disease and syndrome.2.Yishen Jianpi Tongluo method and Yishen Jianpi method alone can reduce proteinuria levels and reduce proteinuria excretion,of which Yishen Jianpi Tongluo method is more effective,so as to control or delay the further development or even worsening of diabetes.3.Yishen jianpi tongluo method can increase the glomerular filtration rate and improve the renal function of the patient in the short term,but the long-term efficacy still needs further evaluation.4.Yishen Jianpi Tongluo method and Yishen Jianpi method alone have obvious advantages in lipid metabolism and can improve the body disturbance of lipid metabolism raises the level of HDL-C.5.Throughout the clinical observation,the patient had no adverse drug reactions and intolerance,and the safety was good.