Clinical analysis of diabetic nephropathy by rhubarb-based medicine enema.

Objective To observe the clinical effect of type 2 diabetic patients with renal insufficiency by rhubarb-based medicine enema and analyze the related factors affecting the therapeutic effect. Methods 140 type 2 diabetic patients with both type 2 diabetic nephropathy and chronic renal insufficiency were randomly divided into four groups,conventional treatment group(32 cases):conventional oral drug treatment,rhubarb enema group 1(38 cases):conventional therapy plus rhubarb enema two times per day,rhubarb enema group 2(33 cases):conventional therapy plus rhubarb enema once per day,mixed enema group(37 cases):conventional therapy plus rhubarb enema once per day and an enema of medicinal carbon tablets per day. Results The total effective rate of rhubarb enema group 1,mixed enema group,rhubarb enema group 2 was 84.2%,78.4%,66.6%,respectively,the total effect of rhubarb enema group 1 was significantly greater than the conventional treatment group(P0.05).After treatment,BUN in rhubarb enema group 1 and mixed enema group were lower than that in conventional treatment group,rhubarb enema group 1(8.54±3.02) mmol/L vs mixed enema group(9.04±2.77) mmol/L vs conventional treatment group(10.85±3.79) mmol/L,respectively;24 urine total protein was lower in rhubarb enema group 1,mixed enema group and rhubarb enema group 2 than that in conventional treatment group,rhubarb enema 1 and mixed enema group less than rhubarb enema 2,rhubarb enema group1(1.66±0.46) g vs mixed enema group(1.81±0.43) g vs rhubarb enema group 2(2.05±0.53) g vs conventional treatment group(2.35±0.57) g.Glomerular filtration rate which in rhubard enema group 1 and mixed enema group more than rhubarb enema group 2,rhubard enema group 1(45.83±8.43) ml/min vs mixed enema group(39.68±7.95) ml/min vs rhubarb enema group 2(37.53±7.85) ml/min vs conventional treatment group(35.23±8.82) ml/min,respectively(P0.01).Multivariate non-conditional logistic regression analysis indicated that the main factors influencing efficacy included age,disease duration,systolic blood pressure,GFR.OR values were 0.890,0.857,0.961,1.054,respectively(P0.05). Conclusion Conventional treatment plus rhubarb enema can not only reduce SCr,BUN,UTP significantly,improve renal function,but also can delay the progress of chronic renal function and improve long-term prognosis of patients with diabetic nephropathy.