| Objective: To observe the effects of Shenshuai fang on TG,TC,LDL-C,inflammatory factors(CRP,TNF-α),kidney in patients with CKD3-4 stage and atherosclerosis through clinical research Function(Scr,BUN,GFR)and atherosclerosis-related indicators(IMT,plaque area),further elaborate on the pathogenesis of TCM and CKD atherosclerosis The relationship between Shenshuai fang provides clinical evidence for improving atherosclerosis,microinflammation and renal function in patients with CKD3-4 stage.Methods: From December 2018 to October 2020,selectd 70 cases in nephrology of Affiliated Hospital of Jiangxi University.The patients met CKD 3-4 stage with atherosclerosis,and the TCM diagnosis of spleen-kidney deficiency and turbid toxin type.The patients were divided into the Shenshuai fang group and the control group randomly,35 in each group.The control group was given CKD integrated treatment,and the Shenshuai fang group was treated with Shenshuai fang on the basis of CKD integrated treatment,continuous treatment and observation for 3 courses(12 weeks).Enzyme-linked immunosorbent assay is used to detect TNF-α and APN;automatic biochemical analyzer detects Scr,BUN,CRP,TC,TG,LDL-C.Calculation of patients’ Ccr using Cockcroft-Gault formula.Both groups were measured by color Doppler ultrasound.Both groups were evaluated TCM syndrome scores and clinical efficacy;The safety indexes of the whole course of treatment were monitored.Results: 1.32 cases were included in analysis in the Shenshuai Fang group.31 cases were included in analysis in the control group.A total of 7 cases were removed in both groups.There were no obvious differences in gender,age,CKD staging,CKD primary disease,TCM syndrome scores,inflammation indicators,renal function,adiponectin,IMT,and plaque area(P>0.05);2.Clinical efficacy of Shenshuai fang group and control group after treatment: The total effective rate was 81.25% in the Shenshuai fang group and 67.7% in the control group(P<0.05);3.The amelioration of renal function(Scr,BUN,Ccr):both groups were ameliorated(P<0.05),and the amelioration of those indexes in the Shenshuai fang group was significantly better(P<0.05);4.Two groups in improving TCM syndrome(main symptom and secondary symptom)scores: the symptom scores of both groups were decreased,of which the Shenshuai fang group decreased more(P<0.05),and the Shenshuai fang group improved the nausea,vomiting,less appetite,dry stools and sticky mouth in the second symptom are more effective(P<0.01).And there were no significant changes in the improvement of the numbness of the limbs in the second symptom(P>0.05);5.Two groups in reducing the CRP and TNF-α: those indexes in both groups were reduced(P<0.05).The levels of indexes in the Shenshuai fang group were reduced more(P<0.05);6.Improvement of AS in two groups: Both groups of patients have a certain degree of improvement(P<0.05).Shenshuai fang group can improve the indexes of AS(TC、TG、LDL-C、IMT、APN)significantly(P<0.05).In the three courses,the plaque area of Shenshuai fang group was reduced more and significantly(P<0.05).Conclusion: The traditional Chinese medicine compound Shenshuai Recipe can reduce adiponectin,inflammatory factors,blood lipid-related indicators,carotid artery intima-media thickness,and reduce plaque area in patients with CKD3-4 and atherosclerosis.The mechanism may reduce the level of adiponectin in the patient’s body,inhibit the expression of inflammatory factors CRP and TNF-α,improve the micro-inflammatory environment,thereby reducing the lipid metabolism disorder in the body,and ultimately delay the progression of CKD and atherosclerosis. |
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