Effect Of Shenwei Compound On Nutritional Status In Non-dialysis Patients With Chronic Kidney Disease

Research background and purpose:Chronic Kidney Disease(CKD)is a serious public health problem in the world,the incidence of which accounts for about 13% of the world’s population.The number of people with CKD in China is about 132 million,accounting for about 9.1% of the global population,ranking the first in the world.With the increasing number of patients with chronic kidney disease,the prevalence rate of malnutrition in CKD,a common complication of CKD,is also on the rise.According to statistics,the incidence of malnutrition in patients with CKD is about 22.7%,especially in patients with stage CKD3-5.Its main mechanism of action is related to a variety of factors,such as reduced protein energy intake,increased energy consumption,protein loss,persistent inflammation,metabolic acidosis,endocrine disorders,intestinal flora changes and depression.The occurrence of malnutrition will lead to further impairment of renal function in patients,showing a vicious circle trend.It is one of the main causes of reduced quality of life and high end-stage mortality in CKD patients.At present,the treatment of CKD patients mainly focuses on such aspects as reducing urine protein,preserving kidney and detoxifying kidney,promoting blood circulation and removing blood stasis,etc.,and there is a lack of effective treatment programs related to malnutrition.The traditional nutritional preparation is expensive and the effect is relatively simple,and it is difficult to make dialectical treatment with fixed components of Chinese patent medicine preparation,so it is not suitable for all patients.Professor Fan Junming,my tutor,innovatively put forward the theory of kidney impotence on the basis of the theory of "impotence" in traditional Chinese medicine,and created the Chinese medicine "Shenwei Compound" to treat chronic kidney disease.Its main ingredients are Astragalus membranaceus,panax notoginseng,kelp,achyranthes sinensis,kelp,angelica sinensis,oyster,rhubarb and so on.A number of animal experiments and clinical experiments have proved that Shenwei Compound can delay the decline of renal function,regulate immunity,improve micro-inflammation state,anti-oxidative stress and other effects.In addition,previous investigations and studies have found that Shenweifang can not only improve the clinical symptoms of patients with CKD,but also have a positive impact on their nutritional status.Therefore,the purpose of this study was to observe the influence of Shenwei Compound on the nutritional status of non-dialysis patients with chronic kidney disease.Materials and Methods:A prospective randomized controlled study was used to select 90 patients with chronic kidney disease who met the inclusion and exclusion criteria and were admitted to the Department of Nephrology,the First Affiliated Hospital of Chengdu Medical College from February 2022 to September 2022.According to the random number table method,they were divided into Shenweifang group,urine Duqing group and medicinal charcoal group,with 30 cases in each group.Biochemical indexes Serum creatinine(Scr),Blood urea nitrogen(BUN)and Hemoglobin(Hemoglobin)were observed before and 12 weeks after treatment in each group.Serum preprotein(PA),Serum albumin(ALB),High density lipoprotein(HDL)and other changes;Extracellular water(ECW)and Protein(Protein,)were evaluated by body composition analyzer.PRO),Body cell mass(BCM),Whole body phase Angle(50k Hz)and other nutritional indexes;The Subjective global assessment(SGA)was used to investigate the nutritional status changes of patients before and after treatment,and the adverse reactions of patients in each group during the experiment were recorded.The differences of various clinical indicators among the three groups before and after treatment were compared,and the differences among the three groups after treatment were compared.SPSS 26.0 was used for statistical analysis of the data,P < 0.05 indicated statistical difference.Result:1.A total of 90 patients participated in the study,including 30 patients in the Shenweifang group,30 patients in the urine Duqing group and 30 patients in the medicinal carbon group.Statistical analysis of age,gender,primary disease and CKD stage of the three groups showed no statistical significance(r > 0.05),indicating comparability.Baseline measurements of biochemical indicators,body composition analysis indicators and nutritional evaluation scores were compared among the three groups,and statistical analysis showed no statistical significance(r > 0.05),indicating comparability.2.No serious adverse events occurred in all enrolled patients,and no withdrawal or shedding cases occurred during follow-up.3.Compared with before treatment,Scr and BUN levels of Shenweifang group,urine Duqing group and medicinal charcoal group were lower than before,the Scr level of Shenweifang group before and after treatment was statistically significant difference(r < 0.05),BUN level before and after treatment was not statistically significant(r >0.05).There was no statistical significance in the Scr and BUN levels of the uroduqing group and the medicated charcoal group before and after treatment(r > 0.05),suggesting that the Shenweifang group was better than the uroduqing group and medicated charcoal group in reducing the Scr level of CKD patients.After treatment,there were no significant differences in Scr and BUN levels among the three groups(r > 0.05).Compared with before treatment,the levels of Hb,ALB,PA and HDL in Shenweifang group were higher than before,the differences were statistically significant(r < 0.05).After treatment,it was suggested that the Shenweifang group was better than the medicated carbon group in improving the ALB level of CKD patients(r< 0.05),and the Shenweifang group was better than the Weiduqing group and medicated carbon group in improving the levels of Hb,PA and HDL(r < 0.05).There were no significant changes in TC,TG,LDL,Ca and P levels in Shenweifang group,urine Duqing group and medicinal charcoal group.4.Compared with before treatment,the human component analysis index protein(PRO),body cell volume(BCM)and 50 k Hz whole body phase Angle in Shenweifang group were increased,with statistical significance(r < 0.05),while the protein(PRO)level in Weiduqing group was decreased.Body cell volume(BCM)and 50 k Hz whole body phase Angle levels were increased compared with before,and the differences were not statistically significant(r > 0.05).Protein(PRO),body cell volume(BCM)and50k Hz whole body phase Angle levels of medicinal charcoal group were decreased compared with before,and the differences were not statistically significant(r > 0.05).There was no statistical significance between Shenweifang group and Uiduqing group(r > 0.05),but there was statistical significance between Shenweifang group and medicinal charcoal group(r < 0.05).Compared with before treatment,the extracellular moisture(ECW)level of Shenweifang group and Uiduqing group was decreased,while that of medicinal charcoal group was increased,with no statistical significance(r >0.05).After treatment,there was no statistical significance between Shenweifang group and Uiduqing group(r > 0.05).The difference between Shenweifang group and medicinal charcoal group was statistically significant(r < 0.05).There were no significant changes in body mass index(BMI)and upper arm circumference(AC)in Houshenweifang group,Uiduqing group and medicinal carbon group.5.Compared with before treatment,SGA score of Shenweifang group was lower than before,and the difference was statistically significant(r < 0.05).After treatment,the comparison between the groups suggested that the treatment group of Shenwei prescription was better than the control group in reducing SGA score,and the difference was statistically significant(r < 0.05).6.Adverse reactions: The incidence of adverse reactions in the treatment group was 10.00% compared with 13.33% and 10.00% in the control group,with no statistical significance(r > 0.05).Conclusion:1.Chinese medicine Shenweifang can reduce serum creatinine,improve renal function and delay the progression of CKD patients in the early stage of medication.2.Chinese medicine Shenweifang can significantly reduce the SGA score of CKD patients,improve the levels of hemoglobin,serum albumin,prealbumin and high density lipoprotein in CKD patients,and positively influence the related indexes of BIA nutritional status in CKD patients,such as protein,body cell volume and 50 k Hz whole body phase Angle,which can significantly improve the whole body nutritional status in CKD patients.