| Objective:1.To explore the effects of traditional Chinese medicine on serum PTH and Calcium-Phosphorus Metabolism in patients with chronic kidney disease stage 3-4 based on the theory of "Junhuo and Xianghuo".2.To explore the pathogenesis and treatment of CKD-MBD in chronic kidney disease stage 3-4 based on the theory of "Junhuo and Xianghuo".Method: 1.Sixty-four CKD-MBD patients who met the inclusion criteria were selected.Among them,the medical syndromes belonged to the syndrome of Pishenqixu and Fengdongxueyu.Randomized and controlled are equally divided into treatment group and control group.Both groups of patients were given conventional basic treatment.The treatment group was given Yishen Xifeng Huayu Decoction on top of this,and the control group was given Alfacalcidol Soft Capsules on top of the regular basic treatment.The observation time was 8 weeks.Observe the changes of the patients’ relevant indicators before and after treatment,including serumcalcium,serum-phosphorus,i PTH,Scr,BUN,e GFR and TCM symptom score,and finally use SPSS26.0 software to perform relevant statistical analysis to Determine the effect of treatment.In addition,through studying ancient books of Chinese medicine,I sorted out and analyzed the theory of primordial "Junhuo and Xianghuo",and clarified the relationship between "Junhuo and Xianghuo" theory and CKD-MBD.2.To clarify the definition,source and function of "Junhuo and Xianghuo" by studying classic Chinese medicine books,and try to discuss the relationship between the two.At the same time,combining the application experience of the " Junhuo and Xianghuo " theory in CKD-MBD,clarify the relationship between "Junhuo and Xianghuo " theory and CKD-MBD,summarize the pathogenesis of CKD-MBD in Chinese medicine,clarify its clinical thinking,and analyze the selected prescriptions.Results:1.Comparison of clinical efficacy: the total effective rate of the treatment group was 86.7%,and the total effective rate of the control group was 66.7%.Through the rank sum test,the total efficacy of the two groups was statistically different(p=0.036<0.05),indicating that the treatment group The treatment result is better than the control group.2.Comparison of the efficacy of TCM syndromes: In the treatment group,4 cases were cured(13.3%),11 cases(36.7%)markedly effective,9 cases(30%)effective,6 cases(20%)ineffective,and the total effective rate was 80%;the control group 1 case was clinically cured(3.3%),markedly effective 5 cases(16.7%),effective 12 cases(40%),ineffective 12 cases(40%),and the total effective rate was 60%.After the rank sum test,the total curative effect of TCM syndromes between the two groups was statistically different(p=0.016<0.05),indicating that the treatment result of the treatment group was better than the control group.3.After treatment,serum-calcium,serum-phosphorus,i PTH,,Scr,BUN,e GFR of the two groups of patients were significantly different from those before treatment(P<0.05),and the treatment group had better improvement of each index In the control group,the difference was statistically significant after independent sample t test(P<0.05).4.Through the study of classic Chinese medicine books,combined with the instructor’s point of view,it is concluded that the source of the Junhuo is innate and nurtured by the blood;the Xianghuo starts from the Junhuo,roots in the Yin essence,and the two fires of the Junhuo and Xianghuo will mutually help each other in the day after tomorrow.The use of Junhuo can control the internal organs,think about things,transport and transform blood;the use of Xianghuo,one can warm the body,two can promote gasification,and three can maintain the balance of Yin and Yang.The relationship between Junhuo and Xianghuo includes the interdependence of lifting,gasification,and physical use.Insufficient vitality is the root cause of the monarch’s loss of friendship,which is an important mechanism for the occurrence of CKD-MBD.Its pathogenesis includes lack of Xianghuo leading to dysfunction of the bones,hyperactivity of the monarch and blood vessel disease,emptiness of the guardian table and internal turbidity,and the loss of communication between the monarch and the lack of clashes are the disease.On the whole,the root cause of CKD-MBD is that patients with chronic renal failure,the vitality is deficient,and the pathogenesis is the lack of Xianghuo in the kidney,while the Junhuo is blazing,and the loss of communication between the Junhuo and Xianghuo is the core,which ultimately leads to the disease of Shaoyang and Chongmai,and the mutual accumulation of Tan Yu Shui Shi.The treatment is to clear the upper and lower temperatures,and take into account the endogenous evils,and the prescription is to use Yishen Xifeng Huayu Decoction.Conclusion:1.The traditional Chinese medicine(Yishenxifenghuayu decoction)under the guidance of the "Junhuo and Xianghuo" theory can improve the increase of i PTH and the disorder of calcium and phosphorus metabolism in patients with chronic kidney disease stage 3to 4,and can reduce the patients’ urea nitrogen,blood creatinine,and improve kidney The spherule filtration rate delays the progression of the disease and improves the clinical symptoms of life of patients.2.The disease of CKD-MBD is rooted in the deficiency of vital energy in the patient.The pathogenesis is insufficiency of Xianghuo in the kidney,and the core of Junhuo is blazing,which eventually leads to diseases of Shaoyang and Chongmai,which are related to "deficiency,dampness,blood stasis,poison,wind,fire" is closely related.The treatment is to Shuxieshaoyang,Wenshentiaozhong,Huatanxingyu.And the prescription is to use Yishen Xifeng Huayu Decoction. |
PDF Full Text Request