Clinical Observation Of Bupi Yishen Quzhuo Decoction In The Treatment Of CKD 3-4 Stage With Sarcopenia With Qi Deficiency Syndrome Of Spleen-Kidney

Objective:To observe the clinical efficacy of Bupi Yishen Quzhuo Decoction in the treatment of CKD 3-4 stage with sarcopenia(qi deficiency syndrome of spleen-kidney),and to preliminarily discuss the treatment of CKD 3-4 stage with sarcopenia by this decoction.Methods:According to the inclusion and exclusion criteria,66 patients who visited the nephrology clinic from December 2021 to February 2023 were collected and randomly divided into control group and observation group,33 cases in each group.Two groups of patients received basic treatment,while the control group was treated with Niaoduqing Granules,and the observation group was treated with Bupi Yishen Quzhuo Decoction for 8 weeks.The changes of TCM syndrome score,ASMI,dominant hand grip strength,6-meter walking speed and SARC-F score before and after treatment were observed in the two groups,as well as the changes of Scr,BUN,eGFR,24 h UPr,ALB and CRP at 0,4 and8 weeks of treatment,and adverse events were recorded.Result:1.66 cases were included in the group,2 cases were lost in the control group and the observation group,and 62 cases were finally included in the statistics.There was no significant difference in general condition,TCM syndrome score,laboratory index and sarcopenia related index between the two groups before treatment(P>0.05).2.The effective rate of TCM syndromes in the observation group was93.55 %,and that in the control group was 74.19 %.The curative effect of observation group was better than control group(P<0.05).3.The clinical effective rate of the observation group was 93.55 %,and that of the control group was 70.97 %.The curative effect of observation group was better than control group(P<0.05).4.After treatment,the total scores of TCM syndromes in the two groups were lower than those in the same group before treatment(P<0.05),and the total scores of TCM syndromes in the observation group were lower than those in the control group after treatment(P<0.05).In the observation group,the individual scores of "fatigue and weakness,shortness of breath and lazy talk,inappetence and indigestion,weakness of waist and knee,abdominal distension,and unformed stool" after treatment were lower than those before treatment(P<0.05),and there was no significant difference in "hypogeusia and no thirst" after treatment compared with before(P>0.05).In the control group,the individual scores of "fatigue and weakness,shortness of breath and lazy talk,inappetence and indigestion,weakness of waist and knee,abdominal distension" after treatment were lower than before treatment(P<0.05),and there was no significant difference between "unformed stool,hypogeusia and no thirst" after treatment and before treatment(P>0.05).After treatment,the individual scores of "fatigue and weakness,shortness of breath and lazy talk,inappetence and indigestion,unformed stool" in the observation group were lower than those in the control group,and the scores of "abdominal distension" were higher than those in the control group(P<0.05).There was no difference between the two groups in the single score of "weakness of waist and knee,hypogeusia and no thirst"(P>0.05).5.At the 4th and 8th week of treatment,the levels of Scr and BUN in the two groups were lower than those before treatment,and the level of eGFR was higher than that before treatment(P<0.05).The levels of Scr and BUN in the observation group were lower than those in the control group,and the level of eGFR was higher than that in the control group(P<0.05).6.At the 4 th and 8 th week of treatment,the levels of 24 h UPr and CRP in the two groups were lower than those before treatment,and the levels of ALB were higher than those before treatment(P<0.05).The levels of 24 h UPr and CRP in the observation group were lower than those in the control group,and the level of ALB was higher than that in the control group(P<0.05).7.After treatment,ASMI and dominant hand grip strength of the two groups were not significantly changed compared with those before treatment(P>0.05),SARC-F scores were decreased and the 6-meter walking speed was increased compared with before(P<0.05).The SARC-F scores of the observation group were lower than the control group,and the 6-meter walking speed was higher than the control group(P<0.05).8.There was no significant change in the safety indexes of the two groups before and after treatment(P>0.05).All patients had no obvious adverse reactions during the medication.Conclusion:1.Bupi Yishen Quzhuo Decoction can ameliorate patients’ clinical symptoms who suffers from CKD 3-4 stage with sarcopenia(qi deficiency syndrome of spleen-kidney).2.Bupi Yishen Quzhuo Decoction can reduce patients’ Scr,BUN and increase their eGFR who suffers from CKD 3-4 stage with sarcopenia(qi deficiency syndrome of spleen-kidney).3.Bupi Yishen Quzhuo Decoction can reduce patients’ albuminuria,increase their albumin level and improve their microinflammatory state who suffers from CKD 3-4 stage with sarcopenia(qi deficiency syndrome of spleen-kidney).4.Bupi Yishen Quzhuo Decoction can ameliorate patients’ somatic function who suffers from CKD 3-4 stage with sarcopenia(qi deficiency syndrome of spleen-kidney).