Clinical Study On Zhixiong Tongluo Capsule Combined With Traditional Chinese Medicine Enema To Delay The Progression Of Chronic Kidney Disease In Stages 3-5

Objective:Observe the clinical efficacy and safety of Zhi Xiong Tong Luo Capsule in combination with Chinese herbal enema therapy in treatment of patients of chronic kidney disease(CDK)phase 3-5 non-dialysis syndrome of blood stasis,and probe the therapy methods'infl uence on Ang 1-7 and AT-?levels among peripheral serums.Methods:68 inpatients meeting admission standards at Dept.of Nephrology of Chongqing Traditional Chinese Medicine Hospital from Dec.2019 to Dec.2020 were selected.The patients were divided into observed group and control group,and each group had 34 patients.Basic treatment was provided for each group.The observed group used Zhi Xiong Tong Luo Capsule in combination with Chinese herbal enema therapy and the control group used Piperazine Ferulate Tablet in combination with Chinese herbal enema therapy.Treatment courses of both groups were 8 weeks,while TCM enema therapy was used for 2 weeks.CRF symptom rating scale,syndrome of blood stasis symptom rating scale,renal function(Scr,BUN,e GFR),AT 1-7,AT-?and safety indicators before and after treatment were observed and compared,and SPSS 23.0 was used for statistical analysis.Results:1.Comparison of clinical efficacyd and TCM syndromes score scale between the 2 groups:The total effective rate of the observed group was 66.7%,that of the control group was 46.7%,and the difference had statistical significance(P<0.05),but the curative effect of TCM Syndrome was no statistical difference(P>0.05)between the 2groups;the difference in TCM syndrome score scale in different treatment time between the 2 groups was statistically significant(P<0.01),but there was no statistical difference(P>0.05)between the 2 groups;2.Comparison of renal functions between the 2 groups:BUN comparison results between the 2 groups:Wald?²=10.612,P=0.014<0.05,the comparison between the 2 groups had statistical difference(P<0.05),the parameter estimation result OR=e^-1.079=0.339,the 95%CI was(e^-4.451,e^2.293)=(0.011,9.904),and the observed group had statistical difference(P<0.05)in different treatment time;pairwise comparison results:after treatment,the 3 time periods after treatment had statistical significance(P<0.05)in comparison with 0 week of treatment,there was apparent difference(P<0.01)after 4 weeks'treatment,while there was no statistical significance after 4 weeks and 8 weeks of treatment.Scrcomparison results between the 2 groups:Scr comparison results between the 2 groups:Wald?²=14.701,P=0.002<0.01,there was apparent difference between the 2 groups,the estimated margin al means was OR=e^-74.667=3.37e^-33,and the 95%CI was(e^-160.719,e^11.386)=(1.58e^-70,88079.93);the observed group had statistical difference(P<0.05)in different treatment time,pairwise comparison results:pair wise comparison results:after treatment,the 3 time periods after trea tment had statistical significance(P<0.05)in comparison with 0 week of treatment,there was apparent difference(P<0.01)after 2 and 4weeks'treatment,while there was no statistical significance or difference after 4 weeks and 8 weeks of treatment.eGFR comparison results between the 2 groups:Wald?²=12.967,P=0.005<0.01,there was apparent difference between the 2 groups,the parameter estimation result OR=e^8.433=4596.27,and the 95%CI was(e^0.655,e^16.211)=(1.93,10973567.67);the observed group's difference in treatment time hads tatistical significance(P<0.05),pairwise comparison results:after trea tment,the 3 time periods after treatment had statistical significance(P<0.05)in comparison with 0 week of treatment,there was apparent difference(P<0.01)after 2 and 4 weeks'treatment,while there was no statistical significance or difference after 4 weeks and 8 weeks of treatment.3.Ang 1-7 and AT-?level comparison between the 2 groups before and after treatment:Ang 1-7 levels of both groups were higher than before treatment,both groups had significant differences(P<0.01)before and after treatment,and the 2-independent-samplet test of growth rates of both groups before and after treatment showed significant difference between the 2 groups(P<0.01).AT-?levels of both groups were higher than before treatment,both groups had significant differences(P<0.01)before and after treatment,and the 2-ind-ependent-samplet test of growth rates of both groups before and after treatment showed significant difference between the 2 groups(P<0.01).4.There was no serious safety accident or adverse reaction in either group during study.Conclusion:Zhi Xiong Tong Luo Capsule in combination with TCM enema therapy had definite efficacy and was safe in treatment of patients of CDK phase 3-5 non-dialysis syndrome of blood stasis;Zhi Xiong Tong Luo Capsule possibly had anti-inflammatory effect,inhibited TGF-?and adjusted EMT level by increasing Ang 1-7 and AT-?contents to relieve ECM deposition,inhibit RF and slow CDK.Zhi Xiong Tong Luo Capsule deserves clinical promotion and further study.