| Objective(1)To study the clinical effect of Chuanhuang Recipe combined with prostaglandin E1 in treating acute kidney injury on phase 2-4 chronic kidney disease patients.(2)From detecting the concentration of related inflammatory factors before and after treatment in patients with A on C,to study on the mechanism of Chuanhuang Recipe in preventing and treating acute kidney injury on Phase 2-4 chronic kidney disease from the perspective of regulating inflammatory factors.Methods72 A/C patients were admitted to the Department of Nephrology,Shanghai Municipal Hospital of Traditional Chinese Medicine from December 2016 to January 2019 were randomly divided into a treatment group and a control group.Treatment group: general basic treatment + prostaglandin E1 + Chuanhuang Recipe;control group:basic treatment + prostaglandin E1;a total of two weeks of treatment.Observation the change of renal function(Scr,BUN,UA),estimated glomerular filtration rate(e GFR,EPI formula),24-hour urine protein quantitation(24h U-pro),and and serum inflammatory bodies 3 Changes of(NLRP3),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),C-reactive protein(hs-CRP),and urinary insulin growth factor binding protein 7(IGFBP7)in patients before and after treatment.In addition,the clinical efficacy was evaluated by the change of TCM syndrome score and the difference of serum creatinine before and after treatment.Results(1)The clinical efficacy was evaluated by the absolute value of serum creatinine reduction:the total effective rate in the treatment group was 72.2%,and the total effective rate in the control group was 27.8%.(2)Renal function:Scr and BUN were significantly lower in the treatment group than before treatment after two weeks treatment(P<0.01),UA was lower in the treatment group than before treatment(P<0.05),and e GFR was higher than before(P<0.01),and the renal function in the control group were also improved than before,but P<0.05.Comparing between the renal function of the treatment group and the control group,there were significant differences in Scr,BUN and e GFR(P<0.05),except for UA(P>0.05).(3)Inflammatory factors:the levels of IL-6,TNF-α and hs-CRP in the treatment group were significantly lower than those before(P<0.01).The inflammatory factors were also decreased after 2 weeks in the control group,but P<0.05.In addition,the level of IL-6,TNF-α and CRP in the treatment group were obviously lower than those in the control group(P<0.05).(4)NLRP3:After two weeks,the treatment group of NLRP3 were declined significantly than before(P<0.01),but the control group of NLRP3 had no differences(P>0.05).(5)IGFBP7:After two weeks,the treatment group of IGFBP7 were declined than before(P<0.05),but the control group of IGFBP7 had no differences(P>0.05).(6)24 urinary protein quantification:The treatment group of 24 h U-pro were decresed than before(P<0.05).The control group of 24 h U-pro had no difference(P>0.05).(7)TCM syndrome points: The total scores of two groups were both significantly lower than those before.(P<0.01).Conclusions(1)Chuanhuang Recipe combined with prostaglandin E1 can effectively improve the renal function in A/C patients,and is superior to prostaglandin E1 alone.(2)Chuanhuang Recipe has a effective prevention in A/C patients,the therapeutic mechanism may be related to the regulation of inflammation.(3)Chuanhuangfang combined with prostaglandin E1 can improve the TCM syndrome of A/C patients,and the total effective rate of treatment is 72.2%. |
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