The effect of TCM characteristic therapy on rehabilitation in patients with chronic kidney disease based on information sharing system

摘要

Objective: clinic research information sharing system was designed and invented by National Chinese Medicine Scientific Academy, which provided great convenience for clinical research. To assess the effect of characteristic therapy of Chinese medicine in rehabilitation of chronic kidney disease patients, data mining in a single TCM hospital was conducted. Methods: clinical information of CKD patients were imputed and stored in the information sharing system in a structured way. Patients' information can be communicated via the information sharing system and the hospital HIS interface. Using the ETL tools, data including the diagnosis of TCM syndrome, results of laboratory tests, scores of TCM symptoms and treatment plan were exported from the information sharing system. Then, the data after selecting were transferred into EXCEL form. Results: 333 CKD patients were included. 201 cases were males (60.4%) versus 132 cases of female (39.6%). 92 patients were eliminated because of missing data. 241 cases remained for statistic analysis, including 147 of male (61%) and 94 cases of female (39%). There were 58 cases in CKD stage 3 (24.1%), 64 cases in stage 4 (26.6%) and 119 cases of stage 5 (49.4%). During hospitalization, scores of TCM syndromes and results of laboratory tests of CKD patients were improved after treatment of integration of Chinese and western medicine (P<;0.05). Comparing with the laboratory results of admission, GLU, BUN, SCR, UA, TCO2, 24 hours urine protein, urine WBC, urine BLD and eGFR were significantly improved. We selected eGFR as the primary endpoint for further analysis in order to find out the effective treatment for rehabilitation and to analyze the effect of TCM characteristic therapy in rehabilitation. The eGFR was the dependent variable, indicators with significant difference between the two groups (eGFR rising group and declining group) as the independent variable. Two variables were analyzed in logistic regression analysis in Forwar- : LR way. Results showed that drugs to correct acidosis, Chinese patent medicine to tonify the kidney and spleen and discharge toxin, external application with fructus evodiae, Tongluobao were the beneficial factors to improve eGFR in CKD patients. Conclusion: This system help clinicians easily, quickly and effectively to collect routine clinical data for research analysis. It is an integration of clinic research system worthy to be widely used. On the other hand, the results also indicated that, the characteristic therapy of TCM including Chinese patent medicine, external application with fructus evodiae, Tongluobao were the independent beneficial factors to improve eGFR in CKD patients.