[Efficiency of benazepril combined with wind dispelling and dampness removing chinese herbs on stage 3 chronic kidney disease with wind-dampness syndrome: a prospective study]

Abstract

Objective: To observe the clinical efficiency and safety of Benazepril and wind dispelling and dampness removing Chinese herbs were singly or combined used in patients with stage 3 chronic kidney disease (CKD 3), and to provide effective integrative medicine methods for treatment of CKD 3.

Methods: The CKD 3 was allocated to qi and yin deficiency syndrome, inner disturbance of wind and damp syndrome, stasis in Shen meridian syndrome, and inner accumulation of damp and heat syndrome. Recruited were patients of inner disturbance of wind and damp syndrome accompanied or unaccompanied with the other 3 syndrome types. In the prospective, randomized, double blind controlled study, 60 patients confirmed as primary chronic glomerulonephritis (CGN) were randomly assigned to 3 groups with a total course of treatment for 24 weeks. Patients in the Western medicine group (WM, 23 cases) took Benazepril (10 mg/d). Those in the Chinese medicine group (CM, 20 cases) received treatment by syndrome typing. Those in the combination group (17 cases) used the two methods. The therapeutic efficacy and the occurrence of adverse reactions were observed in the 3 groups.

Results: The inner disturbance of wind and damp syndrome accompanied qi and yin deficiency syndrome and stasis in Shen meridian syndrome was most often seen in these patients. It accounted for 75.0% in the CM group, 60.9% in the WM group, and 82.4% in the combination group. Totally 54 patients completed this trial. Of them, there were 19 in the CM group, 19 in the WM group, and 16 in the combination group. There was no significant difference in the total effective rate of Chinese medicine syndrome among the 3 groups (84.2%, 78.9%, and 87.5%, respectively) (P>0.05). As for the total effective rate of WM, it was obviously higher in the combination group than in the WM group and the CM group (100.0%, 94.7%, and 94.7%, respectively) (P<0.05). The ratio (24 weeks of treatment/pre-treatment ratio) of serum creatinine (SCr) was obviously higher in the WM group than in the combination group (P<0.05), the estimate glomerular filtration rate (eGFR) (24 weeks of treatment/pre-treatment ratio) was obviously lower in the WM group than in the combination group (P<0.05). There was no statistical difference in SCr and eGFR between the CM group and the combination group. The mean and median of 24 h urine protein ratio (24 weeks of treatment/pre-treatment ratio) were less in the combination group than in the other two groups. The urine protein greater than 2.0 g/d occurred in no case. The experimental drug-correlated adverse reaction rate was obviously higher in the WM group than in the CM group (30.4% vs 10.0%, P<0.05).

Conclusions: As for CGN CKD 3 patients, treatment by Benazepril combined with wind dispelling and dampness removing Chinese herbs showed favorable renal protective effects. It delayed the progress of renal failure, significantly improve the overall clinical efficacy. It was an effective treatment method for CGN CKD 3 patients with good patient tolerance and less adverse reactions.