Curative Effect Observation Of Chen's Shen Fu Decoction On Patients With Chronic Kidney Disease(CKD Stage 3A) Of Spleen-kidney Qi Deficiency,Damp Turbidity And Blood Stasis And Its Effect On Serum Fetuin-a

ObjectiveTo evaluate the clinical effect of Chen's Shen Fu decoction on patients with chronic kidney disease(CKD stage 3a)of spleen-kidney qi deficiency,damp turbidity and blood stasis objectively.Changes of clinical symptoms,related clinical indexes and serum Fetuin-A were observed before and after treatment.Then explore the effect of Chen's Shen Fu decoction on related factors of vascular calcification in chronic kidney disease preliminarily,in order to provide creative reference for delaying the progression of chronic kidney disease and controlling vascular calcification in chronic kidney disease.MethodsTotally 70 patients who met the inclusion criteria were enrolled,and were randomly divided into control group and treatment group,35 cases in each group.Control group was treated with western routine therapy,while treatment group was treated with Chen's Shen Fu decoction combined with western routine therapy.The course of treatment was 8 weeks.The changes of serum creatinine(Scr),estimate glomerular filtration rate(eGFR),24-hour urinary protein quantitative(24hUP),blood calcium(Ca),blood phosphorus(P),calcium-phosphorus product(Ca×P),parathyroid hormone(PTH),high sensitivity C-reactive protein(hs-CRP),serum Fetuin-A and TCM syndrome integral were observed before and after the treatment of the two groups.Results1.General data(gender,age,primary disease),related clinical indexes(Scr,eGFR,24 hUP,Ca,P,Ca×P,PTH,hs-CRP),serum Fetuin-A and TCM syndrome integral from both groups of patients before treatment were not statistically different(P>0.05).2.After treatment,the Scr and 24 hUP in the two groups decreased while eGFR increased(P<0.05),and the efficacy of the treatment group in reducing 24 hUP and increasing eGFR was better than that of the control group(P<0.05),but there was no significant difference in the decrease of Scr between the two groups(P>0.05).3.After treatment,the P,Ca×P and hs-CRP in the two groups decreased(P<0.05),and the treatment group had better efficacy than the control group(P<0.05).After treatment,the Ca and PTH in the two groups showed no significant difference with pre-treatment(P>0.05).4.The level of serum Fetuin-A of CKD patients in the two groups was significantly lower than that of the healthy control group(P<0.01).After treatment,the serum Fetuin-A in the two groups increased(P<0.05),and the effect of the treatment group was superior to the control group(P<0.05).5.Correlation analysis: serum Fetuin-A had a positive correlation with eGFR(P<0.05),which meanwhile had a negative correlation with Scr,P,Ca×P,hs-CRP(P<0.05).But it had no significant correlation with 24 hUP,Ca,PTH(P>0.05).6.After treatment,TCM syndrome integral in the two groups decreased(P<0.05),and the treatment group had better efficacy than the control group(P<0.05).7.The total effective rate of comprehensive effect of disease in the treatment group(81.82%)was higher than that in the control group(60.61%)(P<0.05).Conclusions1.Chen's Shen Fu decoction combined with western routine therapy has a significantcurative effect on patients with chronic kidney disease(CKD stage 3a)of spleen-kidney qi deficiency,damp turbidity and blood stasis,can improve symptoms,reduce the excretion of urinary protein and protect renal function better than only using western routine therapy.2.The level of serum Fetuin-A of CKD patients in the two groups was significantly lower than that of the healthy control group,and serum Fetuin-A was positively correlated with eGFR,negatively correlated with Scr,P,Ca×P,hs-CRP,suggesting that the level of serum Fetuin-A of CKD patients in stage 3a has decreased significantly,which may due to the impairment of renal function,the disorders of calcium and phosphorus metabolism and microinflammatory state.3.Chen's Shen Fu decoction combined with western routine therapy had better efficacy in increasing Fetuin-A and reducing P,Ca×P,hs-CRP than only using western routine therapy,suggesting that Chen's Shen Fu decoction plays a certain role in controlling vascular calcification in CKD patients by raising the level of serum Fetuin-A and improving the disorders of calcium and phosphorus metabolism and micro-inflammatory state.