| Objective:The purpose of this study is to observe the effect of yishen huoxue xiezhuo Recipe on the clinical symptoms and the mechanism of its effect on the clinical symptoms and cardiovascular risk factors of the patients with chronic kidney disease in 3-5 stage,and the syndrome differentiation of spleen kidney deficiency and blood stasis turbid syndrome in traditional Chinese medicine.Methods:1.Data source: the outpatients and inpatients in the nephrology department of Hubei Hospital of traditional Chinese medicine from October 2017 to October 2019 should meet the clinical diagnosis of stage 3-5 chronic kidney disease,and the dialectical classification of traditional Chinese medicine belongs to the syndrome of spleen and kidney deficiency,blood stasis and Turbid Toxin.After being discharged,60 cases were finally included and divided into two groups for treatment according to the random number table.2.Treatment method: 60 patients were randomly divided into treatment group and control group,30 in each group.The two groups were given basic treatment such as reducing blood pressure,reducing blood fat,reducing blood sugar and correcting electrolyte disorder.On the basis of the control group,the treatment group was given Yishen Huoxue Xiezhuo Decoction orally,which was made up of Taohong Siwu Decoction and Shenqi Dihuang Decoction.The ingredients were as follows: Taoren 10 g,Honghua 10 g,angelica 10 g,Shengdi 15 g,Chuanxiong 10 g,red peony 10 g,dangshen 15 g,Astragalus 30 g,yam 15 g,Alisma 10 g,Eucommia 10 g,Dipsacus 15 g,Xianling spleen 15 g,mature army 10 g,warm after meals,2 in the morning and evening every day Times,150 ml each time.The course of treatment was 21 days.3.Observe the blood creatinine,urea nitrogen,uric acid,estimated glomerular filtration rate,hemoglobin,serum albumin,fibrinogen(FIB),plasma NT proBNP,D dimer,C-reactive protein,blood pressure and TCM symptom score before and after treatment,and monitor the blood routine,liver function,electrolyte,ECG before and after treatment to evaluate the effect of yishenhuoxuexiezhuo formula on chronic disease Safety of therapeutic effect in patients with renal disease in 3-5 stages.4.The data were collected and sorted out.After statistical data were analyzed by spss21.0.The experimental data were analyzed by means of mean ± standard deviation(x ? ± s)means: for the measurement data conforming to normal distribution,t-test is used.For the efficacy comparison before and after treatment in the same group,paired sample t-test is used,and for the inter group comparison,independent sample t-test is used;for the counting data,x ^ 2 test is used;for the data not conforming to normal distribution,rank sum test is used.P < 0.05 means the difference is statistically significant,P < 0.01 means the difference is statistically significant,P > 0.05 means the difference is not statistically significant.Results:1.From the perspective of TCM syndrome scores,the treatment methods in the treatment group and the control group have certain effects.There was a statistically significant difference between the two groups(P<0.01).After treatment,the difference between groups was statistically significant(p<0.05).2.According to the curative effect of TCM syndromes,15 cases,10 cases and 5 cases were effective and 5 cases were ineffective after treatment in the treatment group,with an overall effective rate of 83%.In the control group,there were 7 effective cases,14 effective cases and 9 ineffective cases,and the overall effective rate was 70%.After treatment,the difference between the two groups was statistically significant(p<0.05).From the main TCM symptoms of the two groups before and after treatment,the comparison within the two groups was p < 0.05,and the symptoms of burnout,lack of food,low back pain,nausea and vomiting,dark complexion,limb sleepiness,palpitation and shortness of breath were improved after treatment.The comparison between the two groups after treatment was p < 0.05,and the improvement of the test group was more significant than that of the control group,with statistical significance.3.From the perspective of clinical comprehensive effective rate,8 patients in the treatment group showed effective results after treatment,17 patients were effective,3 patients were stable,and 2 patients were ineffective,with an overall effective rate of 83.3%.In the control group,there were 3 effective cases,15 effective cases,10 stable cases and 2 ineffective cases,and the overall effective rate was 60%.After treatment,the difference between the two groups was statistically significant(p<0.05).4.According to the related examination indexes of renal function,serum creatinine(Scr),serum uric acid(UA),estimated glomerular filtration rate(eGFR),urea nitrogen(BUN)before and after treatment were compared between the two groups(P<0.05),and the difference was statistically significant.5.From other biochemical indicators,there was no statistically significant difference in Hb,ALB and K between the two groups before treatment(P>0.05),which was comparable.There was no statistically significant difference between the two groups before and after treatment(P>0.05),and no statistically significant difference between the two groups after treatment(P>0.05).6.From the perspective of cardiopulmonary function and inflammatory indicators,there were statistically significant differences between the two groups in NT-probnp,d-dimer,Fib and CRP groups before and after treatment(P<0.05).The difference between the treatment group and the control group was statistically significant(P<0.05).7.From the perspective of blood pressure,there were statistically significant differences in blood pressure between the two groups before and after treatment(P<0.05)and between the two groups(P<0.05).The difference of diastolic blood pressure before and after treatment was statistically significant(P<0.05),and the difference between groups was statistically significant(P<0.05).8.In the 60 patients included in this study,there were no abnormal changes in safety indicators such as electrocardiogram,blood routine,liver function,urine routine,and fecal routine,and no adverse reactions after taking drugs during the 3-week treatment.Conclution:"Yishenhuoxuexiezhuo Decoction" can significantly improve the symptoms of Chinese medicine,such as fatigue,limb sleepiness,palpitation and shortness of breath,improve the efficiency of clinical treatment,reduce the serum creatinine and uric acid,improve the glomerular filtration rate,and reduce the levels of NT proBNP and D dimer,FIB and CRP in patients with chronic kidney disease,so as to improve the cardiopulmonary function This may be because the effective components of "yishenhuoxuexiezhuo Decoction" can improve the hemodynamic state,reduce the circulation resistance and relieve the left ventricular volume load.The mechanism needs further study."Yishenhuoxuexiezhuo Decoction" has definite effect on improving heart and kidney function,enhancing immunity and alleviating local inflammatory reaction.It may be the mechanism of alleviating CKD heart failure symptoms by reducing NT proBNP and D dimer in patients’ plasma,and it has no obvious adverse reaction,which is worth further clinical promotion. |
