| Background:Diabetic Kidney Disease(DKD)is one of the microvascular complications of Diabetes Mellitus(DM),and also the most common cause of end-stage renal disease(ESRD)worldwide.The pathogenesis of DKD includes renal hemodynamic changes,glucose metabolism disorders,inflammatory reactions and podocyte injury.At present,adjusting the lifestyle,lowering blood glucose,controlling blood pressure,blood lipid and urinary protein are the main treatment methods for DKD,which can help to delay the development of this disease.Meanwhile,the traditional Chinese medicine has also provided some effective treatment methods for DKD,which can improve the clinical symptom relief rate and enhance the life quality of patients.The traditional Chinese medicine believes that DKD is named as"Shenxiao" and "Xiaxiao" in ancient medical theory.Modern doctors call it "The Kidney Disease of Xiaokebing".It is considered that its mechanism of TCM is asthenia in origin and excess in superficiality.The original cause is that the body stays insufficient in both qi and yin,and both spleen and kidney turn to be weak.The superficial causes include blood stasis,phlegm,turbidity,heat evil arise.Among these superficial causes,the heat evil has been paid more and more attention in recent years.Professor Wang analyzed the symptoms of modern DKD patients,advanced a new theory of the mechanism of TCM about the DKD:Heart Meridian Blood-Heat.Based on this theory,he treated the DKD patients in III-IV stage with the method of clearing heat and cooling blood,the curative effect of which has been proved now.In order to promote treatment experience and to benefit patients,Professor Wang established the Xiaokeshen Formula for clinical treatment use.This study aims at observing and evaluating the efficacy and safety of Xiaokeshen Formula.Objective:Through the self-control study,to observe the clinical effect of Xiaokeshen Formula when treating the patients of diabetic kidney disease in III-IV stage,which have been diagnosed as Heart Meridian Blood-Heat Syndrome.Method:We recruited 30 patients from the outpatient department and ward.They were treated with basic treatments including hypoglycemic,blood pressure control,dyslipidemia,diabetes diet,moderate exercise,etc.Meanwhile,taking Xiaokeshen Formula,consists of Pueraria,rhizoma coptidis and Rhizoma Dioscoreae Nipponicae,as an additional treatment.The treatment lasted for 8 weeks.During the treatment we recorded the TCM syndrome scores and physical and chemical examination results.The results are statistically analyzed to evaluate the efficacy of the treatment.Result:1.After treatment with Xiaokeshen Formula,the total effective rate of the disease was 73.3%,and the effective rate was 13.3%;the total effective rate of TCM symptom improvement was 86.7%,and the effective rate was 36.7%.2.The level of urinary protein decreased significantly after treatment.The urinary ACR decreased from 191.053±89.655mg/g to 120.398±59.503mg/g(P<0.01),and the 24-hour urine protein quantity decreased from 2.077±1.147g/24h to 1.299±0.868g/24h(P<0.01);blood lipids and blood glucose levels also decreased,total triglyceride index decreased from 2.326±1.374mmol/L to2.083±1.198mmol/L(P<0.05),fasting blood glucose index decreased from 7.337±1.659 mmol/L to 6.674±1.450 mmol/L(P<0.01).3.There are no obvious side effects occurred during the treatment.The liver and kidney functions index were within the normal range before and after treatment,and there was no significant change in them(P>0.05).Conclusion:Xiaokeshen Formula has the effect to improve disease performance of DKD patients,which can alleviate the TCM symptoms,reduce its proteinuria index,improve kidney function,and help regulate its glycolipid metabolism,and then delay the progression of DKD.Xiaokeshen Formula has been proved to be safe,and it is easy to be accepted by patients. |
PDF Full Text Request