Effect Of Jianpi Yishen Huayu Xiezhuo Method On Protein-energy Wasting In CKD3～4 Patients

Objective:By observing the spleen and tonifying kidney and dissipating phlegm and blood stasis method,anthropometric indicators,nutritional biochemical indicators,renal function and hypersensitive C-reactive protein in patients with chronic kidney disease,3-4 stages of spleen and kidney qi and yin deficiency and dampness and phlegm obstruction Effects of(Hs-CRP),interleukin(IL-6)and SGA scores,and explored the effects of Jianpi Yishen and Huatan Xiezhuo on the protein energy expenditure status of patients with stage CKD 3-4 and evaluated their clinical efficacy.Further explore the related mechanisms of Jianpi Yishen,Huatan Xiezhuo method to improve the state of protein energy consumption and delay the progression of chronic kidney disease,open up new ideas for the treatment of chronic kidney disease and improve protein energy consumption,and provide clinical argument and theory.Methods: Sixty patients with CKD3-4 spleen and kidney qi and yin deficiency and dampness and phlegm obstruction who were eligible for inclusion were randomly divided into treatment group and control group.On the basis of general treatment,the two groups were treated with Jianpi Yishen and Huayu Xiezhuo Decoction,and the control group was given orally with compound(complex α-ketoic acid tablets)for 12 weeks as a course of treatment.One course of treatment,observe and record the BMI,TSF,MACA,serum creatinine,urea nitrogen,albumin,prealbumin,hemoglobin,SGA total score,serum Hs-CRP,IL-6 and TCM clinical before and after treatment Symptom scores and other indicators were compared statistically to evaluate the clinical efficacy of the two groups.Results:The total effective rate of the treatment group was 86.67%,which was significantly higher than the total effective rate of 53.33%in the control group(P<0.05).In the total score of TCM symptoms,both groups decreased,and the total effective rate of the treatment group was83.33% higher than that of the control group(P<0.01).The treatment group improved the waist and knees or low back pain,five upset heat,limbs,dull complexion,nausea and vomiting,skin malocclusion,limb numbness,nocturia,and the effect was significantly better than the control group(P<0.05).In the improvement of fatigue,dry mouth,dry throat,poor appetite,abdominal distension,and sticky mouth,the effect was significantly better than the control group(P<0.01).There was no significant change in body index,thickness of triceps skin fold,and muscle circumference of upper arm in the two groups after treatment(P>0.05).The serum creatinine and urea nitrogen levels in the two groups were lower than those before treatment,and the improvement of renal function in the treatment group was higher than that in the control group(P<0.05).The levels of albumin,prealbumin and hemoglobin in the two groups were higher than those before treatment,and the treatment group was better than the control group in increasing albumin and prealbumin(P<0.05).The treatment group was higher in hemoglobin than in the control group.The group had a very significant advantage(P< 0.01).The SGA scores of the two groups were lower than those before treatment,and the treatment group had a very significant advantage(P<0.01).In terms of serum Hs-CRP,the Hs-CRP levels in both groups decreased,and the treatment group was better than the control group(P<0.05).In the IL-6area,the IL-6 level in the treatment group decreased,and the IL-6 level in the control group was lower.There was no improvement before treatment(P > 0.05).The therapeutic effect of the treatment group was significantly better than that of the control group(P<0.01).Conclusion: Treatment of patients with chronic kidney disease with spleen and kidney qi and yin deficiency and dampness and phlegm obstruction with chronic spleen,kidney and phlegm and phlegm and turbidity.The results showed that they can improve their clinical symptoms and signs and increase albumin and prealbumin.,biochemical nutritional indicators such as hemoglobin increased,and reduced SCA total score,reducing serum creatinine,urea nitrogen and other renal function indicators.It can also significantly improve the level of hypersensitive C-reactive protein and interleukin-6 in patients,so this method can reduce the microinflammation state of patients to a certain extent,reduce protein decomposition,thereby increasing albumin,prealbumin levels and improving protein energy consumption.There were no adverse reactions during the study,and the efficacy of this experiment was safe and accurate.