Effect Of Colonic Dialysis Combined With Yishen Decoction On Serum SIRT6 And MCP-1 Levels In Non-dialysis CRF Patients

Objective:To explore the effect of Yishen decoction on the levels of serum SIRT6 and MCP-1 in non-dialysis CKD3-5 stage patients.To provide theoretical basis for further exploring the strategy of traditional Chinese medicine transcolonic dialysis in the prevention and treatment of chronic kidney disease.Methods:According to the inclusion and exclusion criteria,the patients with stage CKD3-5non-dialysis hospitalized in the department of nephrology of our hospital from March2018 to July 2019 were randomly divided into control group?n=36?,colon dialysis group?n=36?and Yishen decoction transcolonic dialysis group?n=36?.The general data of sex,age,body mass index?BMI?,mean arterial pressure?MAP?and primary disease were collected.After 4 weeks of treatment,serum samples were collected,and the levels of creatinine?Scr?,blood urea nitrogen?BUN?,uric acid?UA?,hemoglobin?Hb?,albumin?Alb?,parathyroid hormone?PTH?,serum calcium(Ca²⁺),serum phosphorus(P^3-),total cholesterol?TC?and triglyceride?TG?,hypersensitive C-reactive protein?hs-CRP?were observed before and after treatment.ELISA method was used to determine the changes of serum SIRT6 and MCP-1 levels in each group before and after treatment.The indexes of each group before and after treatment were compared,and the correlation between SIRT6,MCP-1 and each index was analyzed by Pearson test.Results:1.Comparison of general information:there was no significant difference in age,sex,BMI,MAP and primary disease among the three groups.2.Comparison of biochemical indexes,SIRT6 and MCP-1 levels among the three groups before treatment:there was no significant difference in the levels of BUN,Scr,UA,PTH,Hb,Alb,Ca²⁺,P^3-,TG,TC,hs-CRP,SIRT6 and MCP-1 among the three groups before treatment.3.Comparison of biochemical indexes and levels of SIRT6 and MCP-1 in each group before and after treatment:compared with those before treatment,BUN,Scr and UA in the control group decreased after treatment?P<0.05?,but there was no significant difference in other indexes?P>0.05?.In colon dialysis group,BUN,Scr,UA,hs-CRP and MCP-1 decreased?P<0.05?and SIRT6 increased?P<0.05?after treatment,but there was no significant difference in other indexes?P>0.05?.After treatment with Yishen decoction,the levels of BUN,Scr,UA,hs-CRP and MCP-1decreased significantly?P<0.05?,while the level of SIRT6 increased significantly?P<0.05?,but there was no significant difference in other indexes?P>0.05?.4.Comparison of biochemical indexes and levels of SIRT6 and MCP-1 in each group after treatment:compared with the control group,BUN,Scr,UA,hs-CRP and MCP-1 in colon dialysis group and Yishen decoction group decreased?P<0.05?after treatment,SIRT6 increased?P<0.05?.Compared with colon dialysis group,the levels of BUN,Scr,UA,hs-CRP and MCP-1 in Yishen decoction group decreased?P<0.05?significantly after treatment,SIRT6 increased?P<0.05?,and the difference was statistically significant.5.Correlation analysis:Pearson correlation analysis showed that SIRT6 was negatively correlated with Scr?r=-0.693,P<0.001?,BUN?r=-0.667,P<0.001?,UA?r=-0.684,P<0.001?,hs-CRP?r=-0.696,P<0.001?and MCP-1?r=-0.765,P<0.001?.MCP-1 was positively correlated with Scr?r=0.466,P<0.001?,BUN?r=0.425,P<0.001?,UA?r=0.547,P<0.001?,hs-CRP?r=0.631,P<0.001?.Conclusion:Yishen decoction combined with colon dialysis can significantly increase the level of serum SIRT6 and reduce the level of MCP-1,andAt the same time,the metabolic wastes such as Scr and BUN in CKD3-5 patients were removed.and the effect is significantly better than that of colon dialysis alone,suggesting that Yishen decoction through colon dialysis could reduce the inflammatory state of patients with chronic renal failure,thus delaying the progress of renal function.