| Objective: To observe the changes of serum Osteocalcin(OC)level in patients with chronic kidney disease(CKD)stage 3-4 with spleen-kidney deficiency and dampness-toxicity syndrome and the intervention effect of Jia Wei Liu Wei Di Huang Decocotin,in order to explore Jia Wei Liu Wei Di Huang Decocotin to 3 ? 4 chronic kidney disease(CKD)spleen kidney empty,wet poison intrinsic syndrome in patients with chronic kidney disease mineral and bone metabolism disorder.Methods: 1.Cases were collected from 78 cases of stable 3 ? 4CKD patients admitted to the department of nephrology,Ruikang Hospital affiliated Guangxi University of Traditional Chinese Medicine from 2018 to 2019.They were randomly divided into treatment group(n=42)and control group(n=36).The control group was given a diet of low salt and fat,high quality and low protein,and was given symptomatic treatment such as lowering blood pressure,protecting kidney and detoxification,correcting anemia,and correcting disorders of calcium and phosphorus metabolism.In the treatment group,flavoured liuwei dihuang soup was added,and one dose was taken twice a day.The treatment course of both groups was 8 weeks.Compare the two groups before treatment and 8 weeks after treatment of syndrome of TCM syndrome integral,serum calcium(Ca),phosphorus(P),the entire section parathyroid hormone(i PTH),serum creatinine(Scr),urea nitrogen(BUN),and estimated glomerular filtration rate(e GFR),alkaline phosphatase(ALP)and osteocalcin(OC)changes in the index and safety index.Results: 1.In terms of the curative effect of TCM syndrome,the total effective rate of the control group was 83.33%,and the total effective rate of the treatment group was 92.86%.The curative effect of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.05).TCM syndrome score: the score of the control group was 56.25±5.98 before treatment and 44.67±8.69 after treatment,and the difference before and after treatment was statistically significant(P<0.05);The scores of patients in the treatment group were 57.24±9.28 before treatment and 36.89±5.94 after treatment,(P<0.05);The post-treatment score of the treatment group was significantly lower than that of the control group(P<0.05);In terms of the curative effect of TCM symptoms,the probability of improvement of nausea and vomiting in the treatment group was 80.95%,83.33%,83.33%,73.81%,respectively,and that in the control group was 77.77%,72.22%,80.55%,66.67%,respectively.The results showed that the therapeutic effect of the treatment group was more obvious than that of the control group.(4)comparison of renal function efficacy: the control group was 22.68± 10.67 ml /min before e GFR treatment,and increased to 24.68± 9.36 ml /min after treatment,and the difference between the two groups was not statistically significant(P>0.05),e GFR in the treatment group was 23.25±8.96 ml/min before treatment,and increased to 31.56±7.94 ml/min after treatment,and the difference between the two groups was statistically significant(P<0.05),suggesting that flavoured liuwei dihuang soup had an obvious effect on the improvement of renal function.2.Comparison of laboratory indicators: compared with the control group,the serum Ca level in the treatment group increased significantly,the serum P and ALP levels decreased significantly,and the serum i PTH level did not change significantly.The treatment group and control group after treatment group comparison,to reduce the differences of Scr,BUN,with statistical significance(P<0.05),after treatment with flavored soup 6 flavour glutinous rehmannia,a marked increase in the treatment group e GFR,statistically significant difference(P<0.01),while the control group after treatment,e GFR is increased,but there was no statistically significant difference(P>0.05);There was no significant difference in serum OC before and after treatment in the control group(P>0.05),the serum OC level of the treatment group decreased significantly after the treatment with flavoured Jia Wei Liu Wei Di Huang Decocotin(P<0.01).3.Spearman correlation analysis: serum OC was negatively correlated with e GFR(P<0.01),serum OC was positively correlated with ALP and i PTH(P<0.01);Serum OC was positively correlated with P(P<0.01),serum OC was negatively correlated with Ca(P<0.01).Conclusion: 1.Flavoured Jia Wei Liu Wei Di Huang Decocotin can significantly improve the symptoms of patients with stage 3?4 CKD with spleen-kidney deficiency and dampness syndrome,and reduce the level of Scr and BUN,suggesting that flavoured Jia Wei Liu Wei Di Huang Decocotin has a better kidney protection effec.2.Flavoured Jia Wei Liu Wei Di Huang Decocotin can reduce serum i PTH and P levels,increase serum Ca levels,and correct calcium and phosphorus metabolism disorders,suggesting that Jia Wei Liu Wei Di Huang Decocotin may control secondary hyperparathyroidism and improve CKD-MBD.3.Flavoured Jia Wei Liu Wei Di Huang Decocotin can reduce the serum OC level of patients with stage 3?4 CKD with spleen-kidney deficiency and dampness syndrome,suggesting that the mechanism of flavoured Jia Wei Liu Wei Di Huang in the treatment of CKD-MBD may be related to the reduction of OC. |
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