| ObjectiveIn this clinical observation,the effects and mechanisms of Jian-Pi-Yi-Shen Decoction on CKD were discussed by studying the micro-inflammatory state of CKD2-4 treated with Jian-Pi-Yi-Shen Decoction,and exploring the kidney protection mechanism of Jian-Pi-Yi-Shen Decoction on 5/6Nx SD rats,thus providing new ideas for prevention and treatment of CKD with traditional Chinese medicine.MethodsClinical research:from April 2018 to December 2019,60 inpatients in the Department of Nephrology and outpatients in the Department of Nephrology of Shenzhen Traditional Chinese Medicine Hospital were collected and randomly divided into the reference group(n=30)and the observation group(n=30).Informed consent was signed.All patients were given Jian-Pi-Yi-Shen Decoction orally for 2 months with basic Western medicine treatment,and the changes of microinflammation indexes of 16 patients before and after treatment for 2 months were observed in each group.Observe the TCM symptom score,serum creatinine,glomerular filtration rate and CKD stage before and after treatment for 2 months,and sort out the relevant data for statistical analysis.Animal experimental study:Thirty SD rats were fed adaptively for one week,and then divided into three groups:Sham group,5/6Nx group,Jian-Pi-Yi-Shen decoction group,5/6Nx group and Jian-Pi-Yi-Shen decoction group,which underwent 5/6 nephrectomy to induce CKD model in rats.Sham group underwent two operations at the same time,each time only opening abdominal cavity without damaging kidney tissue.Twelve weeks later,rats were divided into three groups:Sham group(n=6),5/6Nx group(n=6)and Jian-Pi-Yi-Shen decoction group(n=6).The Jian-Pi-Yi-Shen Decoction Group was given the extract of Jian-Pi-Yi-Shen Decoction daily,while Sham Group and 5/6Nx Group were given the same volume of distilled water.Six weeks after intragastric administration,serum and kidney samples were collected.Serum creatinine,urea nitrogen,microinflammatory indexes IL-10,IL-1β and IL-6 were detected by biochemical method.Renal samples were stained with Masson to observe the pathological changes of residual kidney and measure the fibrosis area.ResultsClinical research:(1)before treatment,there is no significant difference in Scr and eGFR between the reference group and the observation group(P>0.05),which is comparable.After treatment,Scr and eGFR in the two groups decreased significantly compared with those before treatment(P<0.05),and the Scr and eGFR in the observation group decreased more obviously,which was significantly different from that in the reference group(P<0.05).(2)Improvement of TCM symptom score:Compared with the control group,the total effective rate of the observation group was 70%,and the total effective rate increased significantly after treatment(P<0.05).There was no significant difference between the reference group and the observation group(P>0.05).After treatment,the scores of TCM symptom scale in observation group decreased significantly(P<0.05),and there was significant difference between the two groups(P<0.05).Animal experimental research:(1)the 5/6Nx rat model was successfully established:the blood urea nitrogen and serum creatinine in 5/6Nx group and Jian-Pi-Yi-Shen Decoction group were significantly higher than those in Sham group,and there were significant differences between 5/6nx group and Sham group,treatment group and Sham group(P<0.05).(2)Results of BUN and Scr in rat serum:Compared with Sham group,the levels of serum creatinine and urea nitrogen in 5/6Nx rats were significantly higher(P<0.05).After 6 weeks,serum creatinine and urea nitrogen levels decreased(P<0.05).(3)Jian-Pi-Yi-Shen Decoction can improve renal fibrosis in 5/6Nx rats:In Masson staining,interstitial fibrosis appeared in 5/6Nx rats,which was about 4 times as much as that in Sham group under microscope(P<0.01).(4)Jian-Pi-Yi-Shen Decoction inhibited the micro-inflammatory state of kidney in 5/6Nx rats.The levels of IL-1 and IL-6 in the 5/6Nx group were both up-regulated and significantly down-regulated after treatment with Jian-Pi-Yi-Shen Decoction(P<0.05).The anti-inflammatory cytokine IL-10 in 5/6Nx group increased significantly(P<0.05).Conclusion:Through clinical observation and animal experiments,this study shows that invigorating Jian-Pi-Yi-Shen Decoction can improve the symptoms of Chinese medicine,reduce the serum creatinine of patients,and protect the renal function structure by improving the microinflammation state,thus achieving the therapeutic effect of delaying the progress of kidney disease,which provides a new idea for treating chronic kidney disease with Chinese medicine. |
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