Clinical Efficacy Study Of Gushukang Capsule Combined With Parathyroid Surgery In The Treatment Of Renal Osteopathy

Objective:To evaluate the clinical therapeutic efficacy of Gushukang capsule on CKD-MBD with liver and kidney deficiency and stasis toxicity syndrome by observing the changes of clinical symptoms and various supplementary examination indexes in patients with chronic kidney disease-mineral and bone disorder(CKD-MBD)before and after parathyroid surgery and after oral Gushukang capsule therapy.Methods:From December 2020 and December 2021,among patients treated in the department of thyroid and breast Surgery of the 960th Hospital of the PLA Joint Logistics Support Force(formerly the General Hospital of Jinan Military Region),80 patients with CKD-MBD who met the inclusion criteria were selected as the study objects and randomly divided into two groups,with 40 cases in each group.After completing the relevant preoperative examinat ion and qual itative local ization diagnosis of parathyroid gland,total parathyroidectomy plus autotransplantation were performed in the control group,and in the test group,on the basis of surgical treatment,orally administered Gushukang capsule for 3 months as a course of treatment,for a total of 2 courses.We observed the changes of clinical symptoms,related laboratory indexes and BMD T-values in the two groups,counted the incidence of bone adverse events in the two groups after treatment,and compared the changes of syndrome scores before and after treatment in the two groups.Results:1.A total of 80 patients were included in this study,including 49 males and 31 females,with 40 patients in each of the control and test groups.There were 3 dropped cases in each group.A total of 319 parathyroid glands were detected in 80 patients,and 1 3 patients with combined thyroid disease underwent thyroid surgery at the same time,including 9 cases in the test group and 4 cases in the control group,with no statistical difference between the two groups(P>0.01).During the perioperative period,three patients developed compl ications,one patient in the test group developed ca lc i um extravasation skin necrosis due to intravenous calcium infusion,one patient in the control group developed acute left heart failure,and one patient suffered from subcutaneous hemorrhage in the operative area,with no statistical difference(P>0.01).2.Patients in both groups showed significant improvement in bone pain and other symptoms compared with those before treatment,and the test group had a significantly lower VAS score than the control group at 6 months postoperatively(Z=-3.78,P<0.001),and their improvement in bone pain was better.3.In both groups,parathyroid hormone and alkaline phosphatase decreased at 3 and 6 months after treatment compared with preoperative levels,and blood Ca levels increased at 3 and 6 months after surgery in both test and control groups,and the improvement of blood Ca levels in the test group was significantly better than that in the control group at 6 months after surgery(Z=9.27,P<0.001).There was some improvement in bone density in the test group at 6 months postoperatively compared to the preoperative period,but there was no significant difference compared with the control group(P=0.209).4.compared with those before treatment,and the syndrome scores of the test group decreased to some extent compared with those of the control group,and the treatment effect was significantly better than that of the control group(Z=-4.10,P<0.001).5.Patients in both groups d id not see any significant abnormalities in blood routine and liver function during the treatment compared to before treatment,no adverse events such as epigastric discomfort occurred.Conclusion:Compared with PTX+AT,the combination of Gushukang capsule with parathyroid surgery can significantly improve the clinical symptoms of bone pain and osteoporosis in renal osteopathy,correct calcium and phosphorus metabol ism,and improve patients’ quality of life.According to syndrome differentiat ion of traditional Ch i nese med ic i ne,Gushukang capsule can promote calcium absorption and improve cl inical syndromes,which provides a new choice for CKD-MBD patients.