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Retrospective Analysis of Clinical Effect of Treating of Chronic Renal Insufficiency of Traditional Chinese Medicine

Author: FuZuo
Tutor: ShengMeiXiao
School: Nanjing University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: chronic renal insufficiency tonifying kidney and spleen and method ofcollaterals drain turbidity method of enema clinical observation for the curative effect
CLC: R277.5
Type: Master's thesis
Year: 2013
Downloads: 41
Quote: 0
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Abstract


Objective:Cases of chronic renal insufficiency received by the Traditional Chinese Medical Hospital in Jiangsu Province for the last three years are analyzed retrospectively. This paper concludes the curative effect of comprehensive therapy of traditional Chinese medicine to stabilize the renal function. It also analyzes the factors affect the curative effect and discusses the treating mechanism for this therapy.Methods:In this study, retrospectively collected215cases from June2009to may2012, Nephrology of the Jiangsu Province Hospital of TCM for treatment of chronic renal failure patients. Those were consistent with chronic renal insufficiency Western diagnosis of non-dialysis patients, Chinese medicine treatment methods conform tonifying kidney and spleen, and method of collaterals drain turbidity, or treatment with enema,treatment>20days. According to whether to take the enema divided to enema group and non-enema group, according to the time of admission into whether there are aggravating factors illness divided into aggravating factors group and no aggravating factors group.Observation before and after treatment, renal function, blood, serum albumin, PTH, UTP and other changes, assess in short and long term evaluation of renal function.Results:1.215patients. Among male137cases, female78cases; oldest97years old, minimum22years, Average age (61.99±15.48) years old; longest duration of22years, the shortest in April, the average duration (7.41±5.77) years; The longest treatment time is76days, the shortest20days, the average (26.49±9.32) days. The maximum admission blood urea40.3mmol/L minimum7.6mmol/L, mean (18.76±6.75) μ mol/L, creatinine maximum692.6u mol/L, minimum178.3u mol/L, mean (366.61±143.55) u mol/L, in which renal azotemia143cases,72cases of renal failure.2.215cases of patients,after treatment, the total effective rate was77.6%; BUN, Scr decline than before treatment, eGFR upward. Difference between before and after treatment was statistically significant (P<0.05). Renal azotemia period and renal failure rates were74.8%,83.3%, difference between the two groups was statistically significant (P<0.05). Spleen and kidney Qi deficiency,Qi yin both deficiency get better treatment (P<0.05); blood stasis, dampness permit get better treatment (P<0.05). Enema group and non-enema group,the total effective rate of the two groups were85.7%,70.9%, the difference between the two groups was statistically significant (P<0.05). There are the aggravated factors group and the no exacerbation factor group,the total effective rate of the two groups were81.9%,72.7%, the difference between the two groups was statistically significant (P<0.05).3.Enema group and non-enema group BUN difference between before and after treatment was statistically significant (P<0.05), Scr, eGFR was not statistically significant (P>0.05). There are the aggravated factors group and the no exacerbation factor group, BUN, Scr, eGFR after treatment the disparity between the two groups has no statistical significance (P>0.05).4.65patients’1/Scr linear regression slope over time, b-value (0.00014±0.000128), b is positive number of18cases of enema group, non-enema group is16, the difference between the two groups was not statistically significant (P>0.05); the aggravating factor group b is positive number of cases is19, no exacerbation factor group set to15, the difference between the two groups was not statistically significant (P>0.05). Speculated that after three years the number of entering in ESRD,31people of the enema group has3people,34people of the non-enema group has15people, the difference between the two groups was statistically significant (P <0.05);33people of the aggravating factors group has4people,32people of the no exacerbation factor group has14people, the difference between the two groups was statistically significant (P<0.05).Conclusion:In this group data of patients renal function as azotemia, renal failure stage, the treatment effect was77.6%, Among the deficiency-syndrome,the spleen and kidney qi deficiency, Qi yin both deficiency get better efficacy. Treatment effect of excess syndromes, blood stasis, turbid damp is superior. The key pathogenesis of Chronic renal is insufficiency of spleen and kidney dampness ecchymosis intrinsic, take "tonifying kidney and spleen, and method of collaterals drain turbidity" as the basic rule, with the enema, help improve the efficacy of treatment. In the course of treatment,correct aggravating factors should be taken seriously.

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