| Objective:Through clinical observation of the effects of Yishen Paidu Recipe on calcium and phosphorus metabolism and related indicators in CKD4 ~ 5 patients with non-dialysis spleen-kidney qi deficiency and turbid-stasis syndrome,the clinical efficacy was evaluated and certain data support was provided for clinical medication.Methods:A total of 60 patients with CKD4 ~ 5non-dialysis spleen-kidney qi deficiency and turbid-stasis syndrome in the inpatient and outpatient departments of the Nephrology Department of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from February 2021 to December 2021 were selected.There were 30 cases in each group.The control group was treated with basic treatment plus calcium acetate and calcitriol capsule.The treatment group was added with Yishen Paidu Recipe on the basis of the control group.After 3 months of treatment,the changes of blood calcium,blood phosphorus,parathyroid hormone,blood creatinine,urea nitrogen,total 25 hydroxyvitamin D,alkaline phosphatase and TCM syndrome score were compared between the two groups before and after treatment.Results:(1)in the blood calcium: the blood calcium of the treatment group was(1.92±0.11)mmol/L before treatment and(2.16±0.13)mmol/L after treatment,the difference was significant(p<0.05)in the group before and after treatment,and(1.93 ± 0.12)mmol/L in the control group before treatment,after treatment,the serum calcium was(2.04±0.17)mmol/l,and the difference was significant(p<0.05).After 3 months treatment,the serum calcium in the treatment group was significantly higher than that in the control group(p<0.05).(2)in the aspect of blood phosphorus: the blood phosphorus of the treatment group was(1.77±0.12)mmol/L before treatment and(1.55±0.16)mmol/L after treatment,there was a significant difference between before and after treatment(p<0.05);the mean blood phosphorus of the control group was(1.78 ± 0.13)mmol/L before treatment,the mean value of serum phosphorus after treatment was(1.68±0.24)mmol/L,and the difference was significant(p<0.05).After 3 months treatment,the blood phosphorus of the treatment group decreased more obviously than that of the control group,and the difference between the groups was significant(p<0.05).(3)in the Parathyroid hormone: in the treatment group,the Parathyroid hormone before treatment was(203.38±48.53)pg/L,and after treatment was(145.10±35.07)pg/l,the difference was significant(p<0.05);In the control group,the Parathyroid hormone before treatment was(192.18±50.74)pg/l,and the Parathyroid hormone after treatment was(158.34±48.80)pg/l.there was significant difference between before and after treatment(p<0.05).After3 months of treatment,the Parathyroid hormone of the treatment group was significantly lower than that of the control group(p<0.05).(4)in Alkaline phosphatase: in the treatment group,the Alkaline phosphatase was(77.45±14.65)pg/L before treatment and(71.83±10.44)pg/L after treatment.There was no significant difference between before and after treatment(p>0.05);In the control group,the Alkaline phosphatase was(77.34±10.54)pg/L before treatment and(73.66±17.47)pg/L after Alkaline phosphatase treatment.There was no significant difference between before and after treatment(p>0.05),there was no significant change in Alkaline phosphatase(P>0.05).(5)In terms of total 25 hydroxy vitamin D: in the treatment group,the total 25 hydroxy vitamin D was(26.29 ± 9.73)ng/ml before treatment and(44.26 ± 12.52)ng/ml after treatment.There was significant difference between before and after treatment(p<0.05).Control group: the total 25 hydroxy vitamin d before treatment was(25.33±8.16)ng/ml,and the total 25 hydroxy vitamin d after treatment was(40.06 ± 10.90)ng/ml.there was significant difference between before and after treatment(p<0.05).After 3months of treatment,the level of total 25 hydroxy vitamin D in the two groups was higher than that before,but there was no significant difference between the two groups(p>0.05)(6)in serum creatinine: in the treatment group,the serum creatinine was(359.62 ± 66.98)ummol/L before treatment and(319.38 ± 45.9)ummol/L after treatment,the difference was significant(p<0.05).In the control group,serum creatinine was(355.28±59.16)ummol/L before treatment and(336.72± 60.58)ummol/L after treatment.There was no significant difference between before and after treatment(p>0.05).After 3 months treatment,the serum creatinine in the treatment group was significantly lower than that in the control group(p<0.05).(7)in urea nitrogen: before treatment,the urea nitrogen was(21.58±3.27)ummol/l,after treatment,the urea nitrogen was(16.89±4.03)ummol/l.the difference between before and after treatment was significant(p<0.05).Control group: urea nitrogen was(21.82±3.59)ummol/L before treatment and(19.12 ± 5.47)ummol/L after treatment.There was no significant difference between before and after treatment(p>0.05).After 3 months treatment,urea nitrogen in the treatment group decreased more significantly than that in the control group,and the difference between the groups was significant(p<0.05).(8)in TCM symptom scores: after 3 months of treatment,the TCM symptom scores of the two groups were decreased compared with those before treatment,and there were significant differences between before and after treatment(p<0.05),but the improvement of TCM symptom scores of the treatment group was more obvious,there was significant difference between the two groups(p<0.05).(9)the total effective rate of the treatment group was 82.76%,and that of the control group was 58.62%.By rank sum test,p=0.034<0.05,the difference between the two groups was significant,the clinical effect of the treatment group is obviously better than that of the control group.(10)the total effective rate of the treatment group was 89.7%,and that of the control group was 75.86%.By rank sum test,p=0.043<0.05,the difference between the two groups was significant.The total effective rate of the treatment group was superior to the control group.Conclusions:(1)Yishen Paidu Recipe can significantly reduce the levels of blood phosphorus,parathyroid hormone,blood creatinine and urea nitrogen in patients with non-dialysis spleen-kidney Qi deficiency and turbidity-stasis syndrome in CKD 4 ~ 5,and increase the levels of blood calcium and25-hydroxy vitamin D.(2)Yishen Paidu Recipe can obviously reduce patients’ TCM symptom score and improve patients’ clinical curative effect and disease total curative effect.(3)Yishen Paidu Recipe can effectively regulate the disorder of calcium and phosphorus metabolism,improve the clinical symptoms and delay the progress of renal function. |
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