Professor Liu Ximing's Treatment Of Stage G2?3 (A2?3) Clinical Summary Of Diabetic Nephropathy

ObjectiveTo observe the clinical efficacy of Professor Liu Ximing in the treatment of diabetic kidney disease G2-3(A2-3),and to summarize Professor Liu Ximing's clinical experience in the treatment of DKDG2-3(A2-3).Method1.Collecting 35 patients who were admitted to the clinic of Professor Liu Ximing from January 2015 to December 2018 and met the diagnostic criteria for DKDG2-3(A2-3)and included the standard and exclusion criteria,and given basic treatment and taking Chinese medicine prescribed by Professor Liu Ximing.2.At the first visit,4 weeks,8 weeks,and 12 weeks as the node,fill in the "Clinical Observation Table for DKDG2-3(A2-3)",record the patient's condition data,and observe changes in the urinary microalbumin creatinine ratio,serum creatinine,glomerular filtration rate,urea nitrogen,blood uric acid,glycosylated hemoglobin,blood sugar and TCM symptom scores.3.Standardize the collected data into the EXCEL 2016 database.4.Using SPSS22.0,analyze the patient's case data by using the method of self-control.Result1.General information:Of the 35 patients included,25 were male and 10 were female.The age ranged from 26 to 75 years old,with an average age of 54.80±11.77 years old,mainly concentrated in the middle-aged and elderly population between 41 and 80 years old.The course of diabetes is distributed between 3 and 30 years,and the average duration of disease is 11.86±6.77 years.Among them,the most common disease course is 6-10.The course of diabetic nephropathy was distributed between 1 and 10 years,with an average duration of 3.23±2.26 years,and 29 patients had a disease duration of ?5years,and only 6 patients with a course of 6-10 years.2.Changes in DKD staging before and after treatment:The highest number of patients before treatment was 20 cases in G3bA3 stage and 8 cases in G3aA3 stage.The highest number of patients after treatment was11 cases of G3aA3,8 cases of G2A3,and 7 cases of G2A2.3.Urine protein:After 12 weeks of treatment,the urinary microalbumin creatinine ratio was significantly different from that at the time of first visit(P<0.01),from 533.622±203.24 mg/g at the first visit to 353.36±133.13mg/g at 12 weeks after treatment.4.Renal function:After12 weeks of treatment,serum creatinine,glomerular filtration rate,urea nitrogen,and blood uric acid were significantly different from those at the time of first visit(P<0.01),and serum creatinine was 153.33±30.89umol/at the time of first visit decreased to 111.98±21.45umo1/l at12 weeks after treatment;urea nitrogen decreased from 10.77±3.25mmol/l at the time of first visit to 8.54±2.72mmol/l at 12 weeks after treatment;blood uric acid decreased from 415.24±72.79umol/l at the time of first visit to 358.03±50.55umol/l at 12 weeks after treatment.The glomerular filtration rate increased from 41.85±10.10mL/(min·1.73m2)at the time of first visit to 59.77±12.87mL/(min·1.73m2)at 12weeks after treatment.5.Glycolipid metabolism:After 12 weeks of treatment,glycated hemoglobin,fasting blood glucose and 2 hours postprandial blood glucose were significantly different from those at the time of first visit(P<0.01),and glycated hemoglobin decreased from 7.32±0.54%at the time of first visit to 6.78±0.43%at 12 weeks after treatment;fasting blood glucose decreased from 8.31±1.54mmol/l at the time of first visit to 7.18±0.9mmol/l at 12 weeks after treatment.The blood glucose level after 2 hours of meal decreased from 10.19±1.66mmol/l at the time of first visit to 8.64±0.94mmol/l at 12 weeks after treatment.6.TCM symptom scores:After 12 weeks of treatment,TCM symptom scores continued to decrease,which was significantly different from the first visit(P<0.01).The scores of TCM symptoms decreased from 49.58±8.92 at the time of first visit to 17.05±6.88 at 12 weeks.The six main symptom scores of fatigue,lower extremity edema,nocturia frequency,dry stool,blurred vision,and urinary foam were significantly different compared with the first visit at 12 weeks(P<0.01).7.Distribution of syndromes:The main syndromes of 35 patients are:qi and yin deficiency,spleen weakness,spleen and kidney deficiency,blood stasis,turbid internal resistance,and damp heat.8.Medication rule:Each prescription drug was between 4-12 flavors,mostly 6 flavors.The top ten Chinese medicines used in the frequency are:danshen(Salvia miltiorrhiza Bge),shenghuangqi(Radix Astragali seu Hedy sari),maidong(Radix Ophiopogonis),yuzhu(.Rhizoma Polygonati Odorati),chuanshanlong(Dioscorea nipponica),nvzhenzi(fructus ligustri lucidi),taizishen(Radix Pseudo stellar iae),pugongying(Herba Taraxaci),beishashen(Radix Glehniae),shengshanyao(Rhizoma Dioscoreae).Conclusion1.35 cases of DKD G2-3(A2-3)patients with a male to female ratio of about 7:3,mainly 41-60 years old(48.57%)of the middle-aged and elderly population;2.The course of diabetes in patients is mainly distributed in 6 to 10 years(48.57%),and 82.86%of patients have DKD duration ?5 years;3.The pre-treatment staging was mainly G3bA3(57.14%),and the post-treatment staging was mainly G3aA3(31.43%);4.Fatigue(94.28%),lower extremity edema(80.00%),frequent nocturia(80.00%)as the main symptoms;5.The main syndromes are qi and yin deficiency(42.86%)and blood stasis(59.59%);6.After treatment,the UACR decreased by 33.78%,the Scr decreased by 26.97%,and the total score of TCM symptoms decreased by 65.61%.