| Objective:To observe the changes of serum SFlt-1 and urinary protein quantitatively in patients with CKD3a of spleen-kidney qi deficiency clip stasis before and after Chen Shi Jiang Zhuo Fang treatment,and to discuss the effect of Chen Shi Jiang Zhuo Fang on the urinary protein of patients with CKD3a.To provide evidence for the possible mechanism of reducing proteinuria and delayed renal function in patients with CKD.Methods:In this study,66 patients who were diagnosed with CKD3a of spleen-kidney qi deficiency clip stasis at the Affiliated People’s Hospital of Fujian University of traditional Chinese Medicine from February,2017 to January,2018 were selected,and a simple randomized method was used to divide them into the group A and the group B,with 33 cases in each group.Group A was treated with simple western medicine,and group B was treated with Chen Shi Jiang Zhuo Fang treatment on the basis of group A,the course of treatment was 2 months.The serum SFlt-1,Scr,eGFR,24 hours urinary protein quantification and other indicators were compared before and after treatment,and statistical analysis was performed.Results:1.66 cases(33 patients in group A and 33 cases in group B)were diagnosed and included in the spleen-kidney qi deficiency clip stasis,and the general clinical data of the two groups before treatment,including age,gender,24h urine protein quantification,Scr,eGFR,serum SFlt-1,and TCM syndromes,were not statistically significant differences,and were comparable(P<0.05).2.The improvement of TCM syndromes in group B after treatment was significantly better than that of group A(P<0.05).3.Serum SFlt-1 levels in group A and group B were significantly higher than those in the healthy control group(P=0.000).After treatment,both groups of patients with SFlt-1 and 24h urinary protein quantity were reduced,and the difference was statistically significant(P<0.05),and the decrease of group B was better than that of group A(P<0.05).4.After treatment,the eGFR in group B was significantly lower than that before treatment,and the serum creatinine was significantly higher than before treatment.However,after the treatment of eGFR in group A,the decrease was significant(P<0.05),and the increase of serum creatinine was significant,and the difference was statistically significant(P<0.05).5.Correlation analysis:there was a positive correlation between serum SFlt-1 and 24h urine protein quantification(P<0.05),and there was no significant correlation between serum SFlt-1 and eGFR(P>0.05).6.The total effective rate of TCM syndromes in group B and group A was 92.3%and 62.5%,respectively,and group B was better than group A,and the difference was statistically significant(P<0.01).It is shown that the clinical curative effect of Chen Shi Jiang Zhuo Fang decoction combined with western medicine in treating the deficiency of spleen-kidney qi deficiency clip stasis type CKD3a is better than that of the simple western medicine group.7.The clinical efficacy of group B and group A was 80.6%and 60.0%,respectively,the difference was statistically significant(P<0.05).Conclusion:1.The treatment effect of Chen Shi Jiang Zhuo Fang decoction combined with western medicine in the treatment of patients with spleen-kidney qi deficiency clip stasis type CKD3a is significant,which can significantly improve the clinical symptoms of these patients,and the clinical efficacy is significantly higher than that of the simle western medicine treatment group.2.Chen Shi Jiang Zhuo Fang turbidity can reduce the serum SFlt-1 and 24h urinary protein quantification in patients with the deficiency of spleen-kidney qi deficiency clip stasis,and its curative effect is significantly better than that of the simple western medicine treatment group,suggesting that it may reduce the SFlt-1 level,regulate SFlt-1 and VEGF feedback mechanism,restore the renal vascular repair and generation function,alleviate the dysfunction of endothelial cells,and reduce the leakage of proteinuria.3.The treatment of Chen Shi Jiang Zhuo Fang decoction and simple western medicine can not reverse the deterioration of renal function and elevate the glomerular filtration rate,but the combination of Chen Shi Jiang Zhuo Fang decoction combined with western medicine can protect the renal function and delay the development of renal function.It may be considered that it may be associated with significantly reducing the level of proteinuria in patients with the deficiency of spleen-kidney qi deficiency clip stasis,and is an effective prescription for the treatment of chronic renal failure. |
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