Clinical Observation Of Chronic Kidney Diease 2-4 Stage And Esperimental Research On The Intervention Of Renal Fibrosis Treated With Yishenhuayu Decoction

Objective:Through the kidney treated CKD2 party-4 of the patient's clinical curative effect observation and kidney blood serum medicated for HK-2 cells E cadherin,alpha SMA expression experimental study of the role of intervention,objectively evaluate the clinical efficacy of kidney blood party,clarify kidney blood party intervention part of renal interstitial fibrosis mechanism,provide scientific theory and practice basis for clinical application.Methods:1.collected in April 2017-March 2018 in henan university first affiliated hospital of traditional Chinese medicine,a total of 60 patients with renal medicine,and consistent with chronic kidney disease(CKD)2-4 issue of the western medicine diagnosis standard and standard of syndromes of TCM of kidney and blood stasis syndrome.The 60 subjects were divided into treatment group and control group by randomized,controlled study.The control group was given the recommended standard treatment,and the treatment group was treated with the combined standard treatment of kidney-tonifying decoction,and observed for 12 weeks.Compare the renal function,blood routine,liver function and electrolyte results of patients before and after treatment,calculate the level of creatinine clearance(CCr),and record the TCM syndrome points before and after treatment.2.Animal experiment:to prepare the serum of SD rats after gavage.Then will grow in culture plate fusion HK-2 to 80%of the cells were randomly divided into 6groups:normal control group,Ang?stimulation group,5%,10%,20%kidney blood serum medicated group and valsartan drug-containing serum group.After stimulation of 12h,24h and 48h,immunocytochemistry was used to detect the expression of alpha-sma and e-cadherin in each group of cells.Results:1.Clinical efficacy of Yishen Huayu Decoction on CKD2-4 stage kidney deficiency and blood stasis syndrome(1)there was no significant difference between the two groups in the level of SCr,BUN,UA,HGB and CCr before treatment.(2)the TCM symptom score of the two groups was significantly lower than that before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).(3)the SCr and BUN were effectively reduced in both groups after treatment,and the CCr level was improved,and the treatment group was better than the control group(P<0.05).However,serum UA level of both groups was not significant(P BBB 00.05).(4)after treatment,HGB was improved in both groups,but the difference was not obvious(P>0.05).(5)the total clinical effectiveness of the treatment group after 12 weeks was93.33%,and the control group was 80.00%,with significant difference(P<0.05).(6)there was no significant change in AST,ALT,blood K~+and PLT in the two groups,and no obvious adverse drug reactions were observed in the treatment group.2.Intervention effect of Yishen Huayu Recipe containing serum on expression of E-cadherin and a-SMA in HK-2 cells(1)three time points in normal control group E-cadherin highest positive expression,Ang?stimulation group minimum positive expression.Compared with Ang?stimulation group,except for 24 hours and 48 hours in 5%kidney blood serum medicated group expression quantity slightly lower(P>0.05),more than the medicated serum group at all time points were significantly increased(P<0.05),including kidney blood each dose group,with 20%of kidney blood drug-containing serum group is most obvious,the significant difference(P<0.05).(2)three time points a-SMA positive expression quantity of the normal control group,Ang?stimulation group the highest positive expression.In the same group,the expression of a-sma increased gradually over time.Compared with Ang?stimulating group,the drug intervention group at each time point expression are lower,including kidney blood each dose group,with 20%of kidney blood drug-containing serum group is most obvious,the significant difference(P<0.05).Conclusion:1.It can effectively improve the renal function of patients with ckd2-4stage,and can effectively reduce the clinical symptoms of patients,and can effectively control the development of CKD.2.It is possible to regulate the expression of e-cadherin and a-sma in hk-2 cells by regulating the expression of e-cadherin and a-sma in hk-2 cells,and play a role in interfering with renal interstitial fibrosis.