| Objective: To observe the clinical effect of Zuogui Wan modified prescription in the treatment of CKD4 renal bone disease of liver and kidney yin deficiency and its significance in delaying the progression of renal function.Methods: 66 patients with renal bone disease in the Department of Nephrology of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine were selected and randomly divided into treatment group and control group,33 cases in each group.Patients in the two groups at the same time on the basis of diet control,hypotensive,hypoglycemic,control group to take calcitriol capsules,treatment group on the basis of control group treatment combined with Zuogui Wan modified prescription.The treatment course of both groups was 8 weeks.The comprehensive curative effect of CKD-MBD,the change of TCM syndromes curative effect and the adverse reactions during treatment were observed in 2groups before and after treatment.The changes of renal function(BUN,Scr,e GFR),serum calcium(Ca),phosphorus(P),Parathyroid hormone(PTH),bone mineral density and safety indexes in 2 groups before and after treatment were monitored,the comprehensive efficacy was evaluated,and statistical analysis was used to reach a conclusion.Results:1.Comparison of comprehensive efficacy of CKD-MBD: After treatment,the treatment group were significantly effective in 11 cases,effective in 17 cases,ineffective in 4 cases,the casestotal effective rate was 87.5%,the control group were significantly effective in 3 cases,effective in 12 cases,ineffective in 16 cases,the total effective rate was 48.4%.The comprehensive efficacy of the treatment group was better than that of the control group(P<0.05),and the difference was statistically significant.2.Renal function efficacy comparison: After treatment,the treatment group were significantly effective in 11 cases,effective in 14 cases,stable in 6 cases,ineffective in 1cases,the casestotal effective rate was 96.9%,the control group were significantly effective in2 cases,effective in 6 cases,stable in 9 cases,ineffective in 14 cases,the total effective rate was 54.9%.The treatment group curative effect of kidney is better than that of control group,(P<0.05),the difference is statistically significant.3.TCM syndrome total scores comparison: The total scores of both groups decreased after treatment compared with before treatment,and the difference between groups was statistically significant(P<0.05).4.TCM syndrome effect comparison: The total effective rate of the treatment group was87.5%,and the total effective rate of the control group was 48.4%.The improvement of TCM syndromes in the treatment group was better than that in the control group.5.Renal function comparison: After treatment,BUN,Scr,e GFR in 2 groups were all improved compared with before treatment,and the effect of treatment group was better than control group(P<0.05).6.Serum calcium and phosphorus,calcium and phosphorus product comparison: All indexes of the two groups were improved after treatment,and the improvement was more obvious in the treatment group,and the difference between groups was statistically significant(P<0.05).7.Bone mineral density(BMD)and parathyroid hormone(PTH)indexes comparison:Both indexes were improved after treatment in the two groups,and the difference between groups was statistically significant(P<0.05).8.RBC and HGB comparison: After treatment,the red blood cell count in the two groups was higher than before,and the difference between groups was statistically significant(P<0.05).9.Drug safety: No adverse reactions occurred in the treatment process.Zuogui Wan modified prescription is a safe and effective prescription for the treatment of CKD4 renal bone disease of liver and kidney yin deficiency.Conclusions:1.Zuogui Wan modified prescription combined with conventional western medicine treatment can effectively improve clinical symptoms,renal function,calcium and phosphorus metabolism,PTH,BMD,improve anemia,and has good safety,can reduce the incidence of fracture in patients with renal bone disease,reduce calcification of blood vessels and heart valves.2.Zuogui Wan modified prescription is safe and effective in the treatment of liver and kidney yin deficiency renal bone disease which is worthy of clinical promotion. |
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