Clinical Study Of "Shen Wei" Prescription On Renal Osteopathy In Maintenance Hemodialysis Patients With Deficiency Of Spleen And Kidney Qi Deficiency And Accumulation Of Dampness And Turbidity

Objective: To study the clinical efficacy and TCM syndrome of ‘Shen Wei’prescription on maintenance hemodialysis(MHD)patients with renal osteopathy and the effect of TCM syndromes of deficiency of spleen and kidney qi deficiency and accumulation of dampness and turbidity,so as to provide new treatment ideas and methods for the prevention and treatment of renal osteopathy with traditional Chinese medicine.Methods: From June 2020 to November 2021,60 maintenance hemodialysis patients with chronic kidney disease stage 5 combined with renal osteopathy with spleen and kidney qi deficiency and accumulation of dampness and turbidity syndrome who met the inclusion criteria were randomly divided into treatment group(30 persons)and control group(30 persons).The control group was given the treatment of improving anemia,controlling blood pressure,controlling blood sugar,intravenous injection of paricalcitol and hemodialysis,while the treatment group was given ‘Shen Wei’ prescription on the basis of the control group,the course of treatment was 12 weeks.To compare the detection indicators(serum calcium,serum phosphorus,serum potassium,iPTH,etc.)and the TCM syndrome score between the two groups,and to evaluate the clinical efficacy and safety of ‘Shen Wei’ prescription for renal osteopathy.Results: After 12 weeks of clinical study,the treatment group and the control group each dropped out 2 cases,finally included 56 patients,the results were as follows:1.After treatment,the TCM syndrome score of the treatment group decreased more significantly than that of the control group(P<0.05).The symptoms of fatigue,bone pain,itching and nausea were significantly improved,and the difference was statistically significant(P<0.05);However,the symptoms of soreness and weakness of the waist and knees,shortness of breath,vomiting,poor appetite,abdominal distention,and inconsequential stool were not significantly improved,and there was no statistical significance(P>0.05).2.After 12 weeks of treatment,iPTH,blood phosphorus and alkaline phosphatase were compared between the two groups,and there was statistical significance(P<0.05).It shows that ‘Shen Wei’ prescription combined with paricalcitol is better than paricalcitol in improving the above indicators.But in the comparison of blood calcium and serum potassium,there was no statistical significance between the two groups(P>0.05),indicating that the two groups have the same curative effect.3.Compared with before treatment,the iPTH,blood calcium,blood phosphorus and alkaline phosphatase of the control group were improved after treatment,and the difference was statistically significant(P < 0.05).Serum potassium decreased after treatment,but the difference was not statistically significant(P>0.05).4.Compared with before treatment,iPTH,blood calcium,blood phosphorus and alkaline phosphatase in treatment group were improved after12 weeks of medication,with statistical significance(P < 0.01).Serum potassium increased after treatment,but the difference was not statistically significant.It indicates that ‘Shen Wei’ prescription is relatively safe to be used in maintenance hemodialysis patients,and serum potassium monitoring is not required before and after administration.Conclusions:(1)‘Shen Wei’ prescription can significantly improve the clinical symptoms of maintenance hemodialysis patients with renal osteopathy,especially the symptoms of fatigue,bone pain,itching,nausea,and improve the quality of life of patients.(2)‘Shen Wei’ prescription combined with paricalcitol can better regulate the state of calcium and phosphorus metabolism disorder,reduce the whole-segment parathyroid hormone,thereby preventing and treating renal bone disease.