Meta Analysis And Clinical Observation Of TCM Compound Syndrome Differentiation In The Treatment Of Early Diabetic Nephropathy

Objective: By systematically evaluating the clinical efficacy of traditional Chinese medicine compound syndrome differentiation treatment of early diabetic nephropathy,combing the composition of effective traditional Chinese medicine compound confirmed by clinical randomized controlled studies,summarizing the rules of medication and combining clinical medication experience,clinical observation.Methods:Systematic retrieval of randomized controlled clinical studies on traditional Chinese medicine compound syndrome differentiation in the treatment of early diabetic nephropathy,including CNKI,VIP,wanfang,Pub Med and Embase databases,was conducted from the database establishment to March 2019,and manual retrieval was combined with computer retrieval.Filtered according to include and exclude standards,to meet the requirements of literature data extraction,using the Review Manager 5.3 software,Meta analysis of compound Chinese medicine syndrome differentiation for treatment of early diabetic nephropathy to give an objective evaluation,and used in literature of traditional Chinese medicine compound composition as a summarized,summarizes drug laws,combined with clinical cases observation curative effect.Results:1.Meta analysis: A total of 20 articles were included,and the publication year was 2007-2019.Among them,13 are qi and yin deficiency and combined syndrome,including 1 qi and yin deficiency and dampness syndrome,and 12 qi and yin deficiency and blood stasis syndrome;5 are spleen and kidney deficiency and combined syndrome,including 3 1 spleen and kidney deficiency and blood stasis syndrome,1 spleen and kidney qi and yin deficiency syndrome and 1 spleen and kidney qi and yin deficiency syndrome and wet stasis syndrome;For liver and kidney deficiency and blood stasis syndrome,a total of 1847 patients were included in the study.The results show that the traditional Chinese medicine compound has a good effect on the treatment of early DN,which can significantly relieve the clinical symptoms of patients,reduce early urine microalbumin,improve blood creatinine,blood sugar,and blood lipid levels,effectively prevent the progress of early DN,and has good safety.2.Statistics of Chinese herbal compound prescriptions: According to the statistics and summary of Chinese medicine prescriptions in the included literature,in terms of the composition of Chinese medicine,from the perspective of single medicine,studies on the combination and inclusion syndrome of qi and Yin deficiency showed higher frequency of astragalus,salvia miltiorrhiza,poria cocos,Chinese yam,radix rehmanniae rehmanniae,peach kernel and radix pseudostellariae.In the study of spleen-kidney deficiency combined with double inclusion syndrome,the frequency of astragalus membranaceus,Chinese yam,poria cocos,Chinese wolfberry,salviae miltiorrhiza and radix rehmanniae was higher.From the perspective of the medicinal properties of the drugs,the study of qi and yin deficiency combined with syndromes in the application of drugs is more cold than warm drugs;the study of spleen and kidney deficiency combined with syndromes is more than cold drugs Sexual drugs;while the mediocre drugs are relatively gentle,the efficacy is peaceful,can be compatible with the certificate,and the application is relatively wide.According to the classification of efficacy of drugs,the highest frequency of the combination of qi and Yin deficiency and the inclusion syndrome was the tonic drugs and the blood-activating and blood-stasis drugs,followed by the heat-clearing drugs.In the study of spleen-kidney deficiency combined with double entrapment syndrome,the highest frequency of qi-tonic drugs was found,followed by drugs to promote blood circulation and remove blood stasis,and drugs to enrich kidney and solidify essence.The majority of the two drugs were used to supplement qi and activate blood and remove blood stasis.According to the classification of drugs used in the literature,the 13 literatures of qi and Yin deficiency combined with double syndrome and the 5 literatures of spleen and kidney deficiency combined with double syndrome were all used to supplement qi and activate blood and remove blood stasis.From the perspective of drug dosage,the top six drugs in the study of qi and Yin deficiency combined with inclusion syndrome were qi tonic,blood-activating and blood-stasis dispelling drugs,heat-clearing drugs,blood-enriching drugs,Yin tonic and water-benefiting and moistening drugs.The amount of qi-tonic drugs was the most in the study of spleen-kidney deficiency combined with double syndrome,followed by heat-clearing drugs and kidney-nourishing and shen-consolidating drugs.Due to the small number of statistical studies,further research is needed.3.Clinical case report: the clinical symptoms of 2 patients improved,the laboratory indicators decreased,and no adverse reactions were observed.Conclusion:1.Meta analysis: Traditional Chinese medicine compound has good curative effect on early diabetic nephropathy and can be used as a diagnosis and treatment plan.2.Traditional Chinese medicine compound statistics and clinical case report:In the selection of medicine prescription,the combination of qi and Yin deficiency and the inclusion of the certificate is dominated by qi tonic drugs.In terms of compatibility,more drugs are used to promote blood circulation and remove blood stasis,Yin tonic drugs,heat-clearing and heat-generating drugs,and water-benefiting and moistening drugs.The combination of spleen-kidney deficiency and syndromes was mainly composed of qi tonic drugs.In terms of compatibility,more drugs were used to promote blood circulation and remove blood stasis,warm tonic drugs,heat-clearing,yin-nourishing and nourishing drugs,and waterbenefiting and moistening drugs.On this basis,according to the actual situation of patients and clinical experience of drug use,appropriate increase or decrease of the dosage of compatible drugs,in order to achieve the best effect.The combination of all drugs,the combination of attack and remedy,the combination of cold and heat,and the emphasis on the removal of pathological products such as blood stasis and heat toxicity,both specimens,in line with the principle of clinical drug use,and the clinical cases proved effective,for the future treatment of early DN syndrome differentiation,in the choice of prescription drug use.