| Objective: To observe the effect of Jian Pi Yishen Huayu Xiezhuo method on atherosclerosis and microinflammatory state in patients with CAPD(spleen and kidney qi deficiency,dampness and stagnation),so as to explore the effect of traditional Chinese medicine on the improvement of renal function and internal environment homeostasis in patients with CAPD,and to provide a new method for preventing complications and improving the survival rate and quality of life of peritoneal dialysis patients.Method: A total of 70 patients(The symptom type is spleen and kidney qi deficiency,wet turbidity and stasis,accompanied by atherosclerosis and microinflammatory state)with maintenance peritoneal dialysis from January 2021 to October 2022 from From the outpatient and inpatient department of the Department of Nephrology,Jiangxi provincial Hospital of Traditional Chinese Medicine,70 patients with maintenance peritoneal dialysis between January 2021 and October 2022 were selected.were enrolled.The patients were randomly divided into 35 cases in the control group and 35 cases in the treatment group using the envelope method.The control group was given peritoneal dialysis therapy,CKD combination therapy and atorvastatin calcium tablets as the basic treatment,while the treatment group was treated with the supplement of Jian Pi Yishen Huayu Xiezhuo Tang in addition to the treatment regimen of the control group,and the experimental cycle was 8 weeks.The TCM syndrome score,renal function indexes(blood creatinine,urea nitrogen),microinflammatory indexes(ultrasensitive C-reactive protein,interleukin-6,tumor necrosis factor-α),lipid indexes(triglycerides,total cholesterol,low-density lipoprotein cholesterol),and carotid intima-media thickness were evaluated in both groups before and after treatment,and the post-treatment safety indexes were observed.Result:1.A total of 9 patients were dropped out and eliminated in this study,and 61 patients were finally included in the trial,including 30 cases in the control group and 31 cases in the treatment group.There were no significant differences between the two groups in gender,age,dialysis age,primary disease,TCM symptom score,renal function index,microinflammation,blood lipid profile,and carotid intimal middle layer thickness(P>0.05).2.Comparison of clinical efficacy: the total effective rate of the treatment group was 83.87%,of which 10 cases were effective,9 cases were effective,7 cases were stable,and 5 cases were ineffective;The effective rate of the control group was 66.67%,including 4 cases of obvious effect,5 cases of effective case,11 cases of stable and 10 cases of ineffect.The total clinical effective rate of the treatment group was higher than that of the control group,and the rank sum test showed that P<0.05,It shows that the treatment group can improve clinical efficacy.3.Comparison of TCM symptom points: Both groups were able to improve the patients’ symptoms,and compared with the control group,except for the improvement of skin nail fault which was not significantly different between the two(P>0.05),the treatment group was able to significantly improve the patients’ TCM symptoms such as fatigue,shortness of breath and lazy speech,lumbago and weakness,chest and epigastric stuffiness,abdominal distension and fullness,and lumbago,and reduce the symptom score(P<0.05).4.Comparison of renal function: both groups could reduce the level of Scr and BUN(P<0.05),and the improvement of renal function in the treatment group was higher than that of the control group(P<0.05).5.Microinflammation: Both groups can improve the patient’s microinflammatory state(P<0.05),compared with the treatment group,the level of hs-CRP,IL-6 and TNF-α can be reduced by a greater extent(P<0.05).6.Blood lipids and CIMT: the levels of TC,TG,LDL-C and CIMT decreased(P<0.05)after the treatment of the two groups,and the levels of TC,TG,LDL-C and CIMT decreased more significantly in the treatment group(P<0.05).7.In terms of safety indicators: there were no obvious adverse reactions after taking the decoction to strengthen the spleen and benefit the kidney and relieve turbidity in the treatment group,and no obvious abnormal changes in vital signs and auxiliary examinations,indicating that Jian Pi Yishen Huayu Xiezhuo method had a certain safety in clinical use.Conclusion: The method of Jian Pi Yishen Huayu Xiezhuo can improve atherosclerosis and micro-inflammatory state in patients with CAPD,improve clinical efficacy,protect the kidney,and slow the progression of the disease. |
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