Clinical Observation Of Qingshen Granules In The Treatment Of Mineral And Bone Abnormal Dampness-heat Syndrome Of Chronic Kidney Disease Without Dialysis

Objective: By observing the clinical effect of Qingshen granules on non-dialysis patients with chronic kidney disease and mineral and bone abnormality of dampness-heat syndrome,the etiology and pathogenesis of mineral and bone abnormality of chronic kidney disease in Chinese medicine is discussed,and the theoretical basis is provided for the treatment of mineral and bone abnormality of chronic kidney disease by Chinese medicine.Methods: 1.Choose between January 2020 and December 2020 in the first affiliated hospital of anhui medical university nephrology outpatient and ward and meet the inclusion criteria,68 cases of patients with(15% loss rate,the increase in 4 cases),according to random number table method is divided into the control group(34 cases)and treatment group(34 cases),two groups of liquorice are to baicalin detoxification drain turbidity grain enema therapy and western medicine therapy,treatment group on the basis of the use clean kidney pellet treatment,a course of 12 weeks.Comparison before and after treatment in treatment group and control group before and after treatment of TCM syndrome integral,including(Sour waist and knee,body drowsiness,bitter dry mouth,sticky mouth,fatigue,nausea,vomiting,bone pain,abdominal distension)score and compare two groups related to renal function indexes,including(glomerular filtration rate,serum creatinine,blood urea nitrogen),compared two groups of chronic kidney disease(CKD)and bone mineral abnormal biochemical indexes,including(serum calcium,phosphorus,parathyroid hormone),comparing two groups of bone markers(beta CTX,TPINP,N-MID)and the clinical curative effect of two groups of patients,and observe treatment that may occur in the process of adverse reactions.Results:1.Clinical efficacy: the overall effective rate of the treatment group(86.7%),the overall effective rate of the control group(60.0%),the therapeutic effect of the treatment group is better than the control group(P < 0.01);Therapeutic effect comparison of TCM syndromes: total effective rate of treatment group(90.0%),control group(66.67%),significant difference(P < 0.01).2.TCM syndrome score: Before treatment,there was no significant difference between the two groups(P > 0 0.05);After treatment,the TCM syndrome score in the treatment group decreased significantly(P < 0.01),but there was no significant change in the TCM syndrome score in the control group(P > 0 0.05).The improvement of scores in treatment group was significantly better than that in control group(P < 0.01).3.Comparison of SCR,EGFR and BUN levels: Before treatment,there was no difference between the two groups(P > 0.05);After treatment,SCR level was significantly decreased(P < 0.01),EGFR level was significantly increased(P < 0.01),BUN level was significantly decreased(P < 0.01)in treatment group;SCR level decreased,EGFR level increased,BUN level decreased in the control group(P < 0.05).The treatment group was better than the control group(P < 0.01).4.Comparison of serum Ca,P and PTH levels: Before treatment,there was no significant difference between the two groups(P > 0.05);After treatment,the serum Ca level in the treatment group was significantly increased(P < 0.05),and the levels of P and PTH were significantly decreased(P < 0.05),while the serum Ca level in the control group was slightly increased(P < 0.05),and the levels of P and PTH had a decreasing trend(P < 0.05),and the treatment group was better than the control group(P < 0.05).5.Comparison of the levels of bone markers β-CTX,TPINP and N-MID: Before treatment,there was no significant difference between the treatment group and the control group(P > 0.05);After treatment,the levels of serum β-CTX,TPINP and N-MID in the treatment group decreased,with statistical significance(P < 0.05).The levels of serum β-CTX,TPINP and N-MID in the control group were decreased,and there was no statistical significance(P > 0.05),but the treatment group was better than the control group(P < 0.05).6.Safety analysis: After 12 weeks of drug treatment,no significant abnormalities were found in the safety indicators of patients in the two groups.Conclusion:1.Qingshen granule has a significant clinical effect on the treatment of non-dialysis CKD-MBD patients with damp-heat syndrome,which can significantly improve the renal function of patients and improve the quality of life;2.Qingshen Granule can significantly improve serum Ca,P,iPTH、ALP levels and bone markers(β-CTX,TPINP,N-MID)levels,and has certain clinical efficacy for CKD-MBD;3.No adverse reactions occurred during the treatment of Qingshen Granules,indicating the high safety of this drug.