Observation On Therapeutic Effect Of Chen’s Shen Fu Decoction On Patients With Chronic Kidney Disease(CKD3a Stage)of Spleen-Kidney Qi Deficiency,Damp-turbid Blood Stasis And Its Effect On NF-κb

ObjectiveThe purpose of this study was to explore the possible mechanism of Chen’s Shenfu decoction delaying the progression of renal function in patients with chronic kidney disease(CKD3a stage)by observing the effects of Chen’s Shenfu decoction on the clinical symptoms,related clinical indexes and the level of nuclear factor-kappa B(NF-κB)in patients with chronic kidney disease(CKD3a stage)before and after treatment,and to explore the possible mechanism of Chen’s Shenfu decoction in delaying the progression of renal function in patients with chronic kidney disease(CKD3a stage).So as to provide new therapeutic ideas for the prevention and treatment of chronic kidney disease with traditional Chinese medicine.MethodIn this study,68 patients with chronic kidney disease(CKD3a stage)diagnosed in the people’s Hospital affiliated to Fujian University of traditional Chinese medicine from February 2020 to February 2021 and TCM syndrome differentiation of spleen and kidney qi deficiency and dampness and turbid blood stasis were randomly divided into control group(n=34)and treatment group(n=34).The control group was treated with routine western medicine,and the treatment group was treated with Chen’s Shenfu decoction on the basis of the control group.The course of treatment of both groups was 8 weeks.The changes of glomerular filtration rate(e GFR),serum creatinine(Scr),24-hour urinary protein(24h UP),urine α1-microglobulin(α1-MG),hypersensitive C-reactive protein(hs-CRP),nuclear factor-kappa B(NF-κB)and TCM syndrome scores were observed before and after treatment in the two groups,and the correlation between them was statistically analyzed.Result1.There was no significant difference in general data(such as age,sex,etc.),related clinical indexes(Scr,e GFR,24 h UP,urine α1-MG,hs-CRP),NF-κB and TCM syndrome scores between the two groups before treatment.2.The levels of Scr,24 h UP and hs-CRP in both groups after treatment were significantly higher than those before treatment(P<0.05),and the curative effect in the treatment group was better than that in the control group(P<0.05).Urinary α1-MG in both groups decreased after treatment,but there was no significant difference between the two groups(P>0.05).3.The level of NF-κB in(PBMCs)of peripheral blood mononuclear cells in the two groups was significantly higher than that in the healthy control group,and after treatment,the level of NF-κB in the two groups was lower than that before treatment,and the curative effect of the treatment group was better than that of the control group.4.Correlation analysis showed that NF-κB in PBMCs was negatively correlated with e GFR,positively correlated with Scr,24 h UP and hs-CRP,and had no significant correlation with urine α1-MG.5.After treatment,the TCM syndrome scores of the two groups were lower than those before treatment(P<0.05),and the curative effect of the treatment group was significantly better than that of the control group(P<0.01).The total effective rate of TCM syndrome of the two groups was 90.63% in the treatment group and 59.38% in the control group.The difference was statistically significant(P<0.05).6.The total effective rate of clinical comprehensive effect of the two groups was 84.38%in the treatment group and 62.5% in the control group,and there was significant difference between the two groups(P<0.05).Conclusion1.Chen’s Shenfu decoction combined with western medicine routine treatment of spleen and kidney qi deficiency,dampness and turbid blood stasis type of chronic kidney disease(CKD3a)patients with significant therapeutic effect,can better improve the clinical symptoms and signs of patients,and the curative effect is better than the routine treatment of western medicine alone.2.Correlation analysis showed that NF-κB was correlated with the degree of renal function damage and inflammatory state,suggesting that reducing the formation of NF-κB in PBMCs can improve renal function,reduce inflammatory state and delay the progression of CKD.3.After treatment,the level of NF-κB in PBMCs of the treatment group was lower than that of the control group,and the urinary protein,renal function and inflammatory state of the two groups were improved after treatment,and the curative effect of the treatment group was better than that of the control group,suggesting that Chen’s Shenfu decoction may improve renal function by inhibiting the expression of NF-κB in PBMCs,reducing inflammatory reaction and reducing urinary protein excretion.