The Effects Of Modified Shenlingbaizhu Powder On Gastrointestinal Dysfunction With Malnutrition-inflammation Complex Syndrome In Patients With Continuous Ambulatory Peritoneal Dialysis With Spleen Deficiency Carrying Blood Stasis Syndrome

Objective: Through the observation of TCM clinical syndrome marks,gastrointestinal function marks,malnutrition-micro-inflammation marks,nutritional index and inflammatory divisor alterations in sufferers with continuous ambulatory peritoneal dialysis(CAPD)with spleen absence and serum stasis syndrome cured by Modified Shenlingbaizhu Pulvis,the influence of Modified Shenlingbaizhu Pulvis on gastrointestinal function and malnutrition-inflammation complex syndrome(MICS)of sufferers with CAPD spleen absence and serum stasis syndrome was investigated.Objective to explore the effect of Modified Shenlingbaizhu Pulvis on the clinical symptoms of CAPD sufferers with spleen absence and serum stasis syndrome and the mechanism of its action.Method: Using a entirely randomized grouping means,67 sufferers who met the inclusion and elimination criteria were separated into 33 cases in the contrast group and34 cases in the remedy group.3 cases of the contrast group fell off during the course of remedy,and 4 cases of the remedy group fell off,60 cases were actually accomplished.Both the contrast group and the remedy group were given CAPD routine basic remedy(reducing blood pressure,correcting anemia,regulating water,electrolyte and acid-base metabolism balance,etc.),the contrast group was given Bifidobacterium bifidum,and the remedy group was given Modified Shenlingbaizhu Pulvis compound granule orally(one dose per day,morning and evening,),both groups were treated for 12 weeks.The alterations of TCM syndrome marks,gastrointestinal symptom scale(GSRS)marks,reflux disease questionnaire(RDQ)marks,Malnutrition-Inflammation(MIS)marks were observed before and later remedy;the discrepancy of BUN,Scr,HGB,ALB,PA,TRF,TC,hs-CRP,G-17,IL-10,IFN-γ before and later remedy was detected and matched between the two groups,and the body mass index(BMI)was calculated.Results: 1.TCM symptom efficacy and TCM symptom score:Main effective rate of TCM syndromes in the remedy group was 83.33%,and that in the contrast group was53.33%.The improvement of TCM syndromes in the remedy group was striking better than that in the contrast group(P<0.05).There was no striking discrepancy in the main marks of TCM syndromes between the two groups before remedy(P>0.05);later remedy,the main marks of TCM syndromes in the two groups diminished which matched with that before remedy,with statistical discrepancy(P<0.05);later remedy,the main marks of TCM syndromes diminished striking matched with the contrast group in the same period(P<0.05).2.BUN,Scr levels:There was no striking discrepancy in BUN and Scr between the two groups before and later remedy(P>0.05),There was no striking discrepancy before and later remedy of BUN in the contrast group(P>0.05).later remedy,BUN in the remedy group diminished striking matched with that in the contrast group in the same period and before the remedy(P<0.05).The alterations of Scr were not striking before and later remedy in the two groups(P>0.05).3.HGB,ALB,TC,PA,TRF levels:There was no striking discrepancy in the above indicators before remedy between the two groups(P>0.05),later remedy,ALB and PA in the two groups were striking taller than before remedy(P<0.05).TRF in the remedy group was striking taller than before remedy(P<0.05).later remedy,ALB,PA,and TRF in the remedy group were all taller than the same period(P<0.05).There was no striking alteration in TRF before and later remedy in the contrast group(P>0.05);there was no striking discrepancy in HGB and TC before and later remedy in the two groups(P>0.05).4.hs-CRP、IL-10、IFN-γ levels: Before the remedy,there was no striking discrepancy in the above indicators between the two groups(P>0.05),later remedy,IL-10 in both groups augmented strikingly matched with that before remedy(P<0.05),and the augment of IL-10 in the remedy group was striking better than that in the contrast group(P<0.05).later remedy,IFN-γ diminished striking in the two groups matched with thatbefore remedy(P<0.05),and the diminution in the remedy group was better than that in the contrast group(P<0.05).There was no striking alteration of hs-CRP in the contrast group before and later remedy(P>0.05).later remedy,hs-CRP in the remedy group were striking diminished which matched with those in the same group before remedy and the contrast group in the same period(P<0.05).5.GSRS,RDQ,MIS score: There was no statistically striking discrepancy in GSRS,RDQ and MIS marks between the two groups before remedy(P>0.05).GSRS and RDQ marks in the two groups diminished later remedy which matched with before remedy(P<0.05),and the diminution extent in the remedy group was striking better than that in the contrast group(P<0.05).There was no striking discrepancy in MIS before and later remedy in the contrast group(P>0.05),and MIS later remedy in the remedy group was striking diminished which matched with that before and during remedy in the same group(P<0.05).6.G-17 level: There was no striking discrepancy in G-17 before remedy between the two groups(P> 0.05);after remedy,G-17 in the remedy group augmented strikingly matched with that before and during the same period of the contrast group(P <0.05);There was no striking discrepancy in G-17 before and after remedy in the contrast group(P> 0.05).7.BMI value:There was no statistically striking discrepancy in BMI between the two groups before remedy(P>0.05),and no statistically striking discrepancy in BMI before and later remedy in the contrast group(P>0.05).BMI in the remedy group later remedy was strikingly taller than that before remedy in the same group and that in the contrast group during the same period(P>0.05).8.There was a positive correlation between TCM symptom marks and GSRS,RDQ,MIS marks and serum G-17 level in CAPD sufferers with spleen absence and serum stasis syndrome(P<0.01).Conclusion:Modified Shenlingbaizhu Pulvis has a striking effect on the clinicalsymptoms of TCM in sufferers with CAPD spleen absence and serum stasis syndrome,and can strikingly improve the gastrointestinal dysfunction and MICS of sufferers.This may be related to the bidirectional regulation of Modified Shenlingbaizhu Pulvis in gastrointestinal function,the increase of ALB,PA,TRF,BMI and other nutritional indicators,the down-regulation of hs-CRP,G-17 and inflammatory divisor IFN-γ,the up-regulation of anti-inflammatory divisor IL-10,and the inhibition of MICS.