The Effect Of Ronghuang Yishen Jiedu Decoction On Pin1 And Axin Peripheral Blood Mononucellular Cells In CKD-MBD Patients Without Dialysis And With Damp-heat Syndrome Of Renal Impairment

Objective:The purpose of this study was to observe the changes of Pin1 and Axin levels in peripheral blood single nuclear cells in patients with non-dialysis CKD-MBD kidney deficiency dampness and heat syndrome.Based on the Wnt/β-catenin signalling pathway,the action mechanism of Ronghuang tonifying the kidney detoxification soup in the treatment of CKD-MBD syndrome of kidney deficiency and dampness-heat.Methods:From October 2021 to October 2022,70 patients with non-dialysis CKD-MB D renal deficiency wet fever syndrome were selected from the nephrology department of Anhui Traditional Chinese Hospital.The control group and treatment group were divided according to the randomized numerical table method.Ten healthy eGFR patients were enrolled from physical examination centers and set as the normal group.The control group was given western medicine and a home-made enema prescription,while the treatment group was given Ronghuang tonifying the kidney detoxification soup for four weeks each,over a period of twelve weeks.Changes in TCM syndromes,serum scr,eGFR,BUN,Ca,P,iPTH,and in peripheral blood single nuclear cells Pinl and Axonal protein were recorded before and after treatment.Peripheral blood mononuclear cells Pinl and Axin were only measured in the normal group.Results:(1)Disease efficacy:CKD-MBD and TCM syndromes after treatment were superior in the treatment group(P<0.05).(2)Chinese medicine evidence points values:there was no difference in the contrast of Chinese medicine proof points worth between the two groups before cure,which was analogous(P>0.05).Cotrasted to the pre-treatment period,there was no prominent imparity between the first and second treatment courses in the control group(P>0.05)and no significant improvement in the third stage(P<0.01).All three courses of TCM syndrome score were dramatically lower in the cure group(P<0.05 or P<0.01).Contrast to the control tranches,all three courses of TCM syndrome score were significantly better in the treatment group(P<0.05 or P<0.01).(3)Renal function index:SCR,eGFR and BUN comparison not different before cure(P>0.05).There was no meaning transformation in the first course of treatment(P>0.05)and no significant improvement in the second or third course of treatment(P<0.05 or P<0.01)compared to the pre-treatment group.All three treatment courses(P<0.05 or P<0.01)were significantly improved(P<0.05 orP<0.01)compared with the first course of cure(P<0.05 or P<0.01)and the third course of treatment(P<0.05)There were no observably impariy between the two groups.(4)Serum Ca,P,iPTH:There were no differences in serum Ca,P,iPTH between the two groups before treatment,and there was comparability(P>0.05).Compared with before treatment,serum Ca and P in control group were significantly improved in three courses(P<0.05 or P<0.01);There was no significant difference between the first and second courses of serum iPTH(P>0.05),and the third course of serum IPTH was dramatically improved(P<0.05).The serum Ca,P and iPTH were markedly ameliorative in the treatment group(P<0.01).Compared between groups,the first course of serum Ca and P in the treatment group had no markedly impayity compared with the control group(P>0.05),the second and third course of treatment were better than the control group(P<0.05 or P<0.01),meanwhile,the improvement of serum Ca and P in the second and third course of treatment group was better(P<0.05 or P<0.01);The iPTH of serum in the treatment group was the highest.There was no significant difference between the first and the second course of treatment and the control group(P>0.05),but the third course of treatment was markedly better than the control group(P<0.05).Meanwhile,the betterment of serum iPTH in the three courses of treatment was better than that in the cure group(P<0.05 orP<0.01).(5)Peripheral blood mononuclear cells Pinl,Axin:Prior to treatment,there was no significant difference between peripheral blood mononuclear cell Pinl and Axin in the two groups(P>0.05);However,compared with the normal group,both patients showed a significant increase in Pinl(P<0.01)and a significant decrease in Axin(P<0.01).After treatment,both groups showed a significant decrease in Pinl(P<0.01)and a significant increase in Axin(P<0.01).In the presence of peripheral blood mononuclear cells,the performance of Pinl and Axin was observably better than that of the control group(P<0.01).(6)Safety index:There was no significant change in ALT,AST,ECG,stool routine+occult sanguis before and after cure,and no untoward effect during treatment.Conclusion:(1)was effective in treating non-dialysis kidney deficiency and dampness and dampness heat syndrome.(2)was effective significantly regulates Pin1 and Axin in peripheral blood mononuclear cells might be the potential mechanisms in clinical treatment of CKD-MBD.