Effect Of Shenkang Injection On Related Indexes Of Protein Energy Wasting In CKD 4-5 Non-dialysis Patients

ObjectiveBy observing the effects of Shenkang injection on the nutritional biochemical indexes,renal function,inflammatory indexes,nutritional risk screening 2002(NRS2002)score and TCM syndrome score of non-dialysis patients with spleen and kidney deficiency and turbidity-stasis syndrome at stage 4-5 of CKD,the clinical efficacy of Shenkang injection on PEW was objectively evaluated.MethodsA retrospective cohort study was used to enroll a total of 120 non-dialysis inpatients with CKD spleen-kidney deficiency,turbidity and blood stasis in the Department of Nephrology in our hospital from June 2019 to December2020,according to whether or not to use Shenkang injection,60 cases were divided into observation group(Shenkang injection + conventional foundation treatment)and60 cases were divided into control group(conventional foundation treatment),using propensity score matching method(PSM)to match patients of two groups with 1: 1match in order to balance confounding bias,observing the serum creatinine,blood urea nitrogen,serum albumin,prealbumin,lymphocyte count,c-reactive protein,hemoglobin,total cholesterol,triglyceride,TCM syndrome integral,NRS2002 score changes of two groups patients after treatment to evaluate the effect of Shenkang injection on the related indexes of protein energy consumption in non-dialysis patients with CKD spleen-kidney deficiency,turbidity and blood stasis syndrome.Results1.A total of 120 non-dialysis patients with CKD 4-5 stages of spleen-kidney deficiency,turbidity and blood stasis syndrome were included.The observation group and the control group had 60 cases each.Before matching,the baseline data of the two groups(disease course,BMI,hemoglobin,etc.)had statistically significant difference.After matching using the propensity scoring method,a total of 86 patients were successfully matched and there was no statistically significant difference in baseline characteristics between the two groups of patients;2.Renal function indicators(serum creatinine and urea nitrogen): After treatment,the serum creatinine and urea nitrogen of the two groups were lower than before treatment,the difference was statistically significant(P<0.05);the decrease of serum creatinine after treatment in the observation group was better than that in the control group.The difference is statistically significant(P<0.05);3.Nutritional indicators(albumin,prealbumin,lymphocyte count):(1)Prealbumin:The prealbumin in the observation group was significantly higher than that before the treatment,and the difference was statistically significant(P<0.05);the difference in prealbumin before and after the treatment in the control group was not statistically significant(P>0.05);The increase of prealbumin in the observation group was higher than that in the control group after treatment,and the difference was statistically significant(P<0.05);(2)Serum albumin and lymphocyte counts: After treatment,the albumin and lymphocyte counts of the two groups were significantly higher than before,and the differences were statistically significant(P<0.05);but there was no statistically significant difference in albumin and lymphocyte counts between the two groups after treatment(P>0.05);4.Microinflammation index(C-reactive protein): The C-reactive protein was lower than before treatment in observation group and control group after treatment,with statistically significant difference(P<0.05);but the difference between the two groups after treatment was not statistically significant(P>0.05);5.Blood lipids,hemoglobin,parathyroid hormone: The total cholesterol,triglycerides,and parathyroid hormone of the observation group and control group after treatment were all lower than before treatment,and hemoglobin was higher than before,with statistically significant difference(P<0.05).But there was no statistically significant difference between the two groups of hemoglobin,total cholesterol,triglyceride,and parathyroid hormone after treatment(P>0.05);6.NRS2002 score: The NRS2002 scores of the observation group and control group decreased after treatment with statistically significant difference(P<0.05);the NRS2002 score of the observation groupafter treatment was significantly lower than control group,which with statistically significant difference(P<0.05);7.After treatment,the total effective rate of the observation group was 44.2%,while the control group was 23.3%.The difference between the two groups was statistically significant(P<0.05).Conclusion1.Shenkang injection can improve the early nutritional biochemical index(prealbumin)of PEW in patients with CKD 4-5 non-dialysis spleen-kidney deficiency,turbidity and blood stasis,reduce NRS2002 score,and improve short-term CKD 4-5non-dialysis patients Malnutrition;2.Shenkang injection(the method of invigorating the spleen and kidney,removing blood stasis and turbidity)combined with conventional western medicine treatment can effectively improve the renal function and TCM syndrome scores of non-dialysis patients with CKD 4-5 stage spleen-kidney deficiency and turbidity and turbidity.The comprehensive curative effect is better than only the conventional basic treatment.