| Objective In this study,we mainly through observing the changes of serum fibroblast growth factor 23(FGF23),fibroblast growth factor receptor(FGFRs),the levels of Klotho numerical value in non-dialysis chronic kidney disease mineral and bone metabolism disorder(CKD-MBD)which patients who with kidney deficiency and damp heat,to evaluated the therapeutic effect and reseach possiblely mechanism about Rong Huang granules(i.e.the Rong Huang tonify kidney detoxification granules).Methods A total of 70 cases of non dialysis CKD-MBD patients with kidney deficiency and damp heat inclusion criteria,were randomly divided into treatment group of 35 cases,35 cases in the control group,the treatment process of the fall of 5 cases,the actual completion of 65 cases,and 20 cases of healthy people were selected as normal control group(hereinafter referred to as the normal group).The treatment group and the control group were treated with corresponding decompression,correction of anemia,correct calcium and phosphorus metabolism disorder,restrain secondary hyperparathyroidism and correct water,electrolyte and acid-base balance disorders and other symptomatic treatment and retention enema with traditional Chinese medicine;the treatment group based on the control group with Rong Huang granules for treatment.Take the method for warm water,three times a day,each time 1 bag.The treatment group and the control group were treated for 12 weeks.Observation of the treatment group and the occurrence of changes in the control group of patients with kidney deficiency and damp heat syndrome,renal function and adverse reactions;and serum calcium before and after treatment in two groups(Ca),phosphorus(P),parathyroid hormone(i PTH),FGF23,FGFRs and Klotho protein level,with normal serum detection FGF23,FGFRs,Klotho protein level was determined and the effect of using SPASS25.0software analyzed statistically according to the experimental results.Results after treatment,the efficacy of CKD-MBD,renal function,TCM syndromes and main symptoms of TCM in the treatment group were observably superior to those in the control group,the differences have statistical significance(P<0.05 or P<0.01).The treatment group 4 weeks and 8 weeks,12 TCM syndromes integral value respectively over the weekend before treatment were observably reduced,the differences have statistical significance(P<0.05 or P<0.01);the control group after 4 weeks of treatment,8 TCM syndromes integral values were decreased in the weekend compared with before treatment had,but the difference between the two groups has no statistical significance(P>0.05),TCM syndrome integral 12 weeks treatment compared with before treatment observably decreased,the difference between the two groups has statistical significance(P<0.05).The treatment group for 8 weeks and 12 weeks of TCM syndrome integral value decreased with the treatment of 4 weeks,the differences have statistical significance(P<0.05 or P<0.01);the control group after 8 weeks of treatment,12 TCM Syndromes of weekend values decrease respectively with 4 weeks of treatment,the difference has no statistical significance(P>0.05).The decline of TCM syndrome scores in treatment group at 4 weekend,8 weekend and 12 weekend were observably different from those in the control group at the same time(P<0.01).The treatment group 4 weeks and 8 weeks and 12 weeks of Scr,BUN and e GFR levels were compared with before treatment,Scr and BUN levels were observably decreased and e GFR levels increased observably,the differences have statistical significance(P<0.05 or P<0.01);the control group for 4 week,8 weeks and 12 weeks,the level of e GFR Scr compared with before treatment were not improved,the differences have no statistical significance(P>0.05),4weeks after the treatment,BUN levels before treatment decreased,but the difference has no statistical significance(P>0.05),BUN level for 8 week and 12 weeks respectively compared with before treatment were significantly lower,the differences have statistical significance(P<0.05).The levels of serum Ca,P and i PTH in treatment group at 4weekend,8 weekend and 12 weekend were observably higher than those before treatment.Serum Ca levels were observably increased,serum P and i PTH were observably decreased,and the differences have statistical significance(P<0.05 or P<0.01).The control group for 4 weeks and 8 weeks,serum Ca P and i PTH were compared with before treatment,serum Ca increased,serum P,i PTH were lower,but the differences have no statistical significance(P>0.05),after 12 weeks treatment,serum Ca increased observably,serum P and i PTH decreased,the differences have statistical significance(P<0.05).Before treatment,the control group,the treatment group and the normal group,serum FGF23,FGFRs,Klotho protein levels are compared,the differences have statistical significance(P< 0.01);the control group treatment group were compared with the normal group,the differences have statistical significance(P <0.01);the control group and the treatment group,the differences have no statistical significance(P > 0.05).After treatment,the treatment group serum FGF23,FGFRs,Klotho protein levels were compared with before treatment,serum FGF23,FGFRs levels were observably decreased,the serum Klotho protein levels were observably increased,the differences have statistical significance(P<0.05);the control group of serum FGF23,FGFRs and Klotho protein levels compared with before treatment,serum FGF23,FGFRs levels were decreased serum Klotho protein level was increased,but the difference has no statistical significance(P>0.05).The levels of serum FGF23,FGFRs and Klotho in the treatment group were significantly improved compared with those in the control group after treatment,and the differences have statistical significance(P<0.05).In the course of treatment,there was no adverse reaction between the treatment group and the control group.Conclusion Rong Huang granules has significant therapeutic effect on CKD-MBD and renal function of non dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome,and has significant improvement in TCM syndromes,main symptoms of TCM and laboratory indexes.It shows that Rong Huang granules can delay the progression of the patients with CKD-MBD kidney deficiency and damp heat syndrome to a certain extent.The levels of serum FGF23 and FGFRs in non dialysis CKD-MBD kidney deficiency and damp heat syndrome patients were significantly higher than those in the normal population.The serum Klotho protein level was significantly lower than that in the normal population,indicating that the levels of FGF23,FGFRs and Klotho protein in patients with kidney deficiency and dampness heat syndrome were abnormal.Rong Huang granules has significant improvement in serum FGF23,FGFRs and Klotho protein levels in non dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome,and decreases serum FGF23 and FGFRs levels,and increases serum Klotho protein level.Rong Huang granule can improve renal function,calcium and phosphorus metabolism disorders and suppress secondary hyperparathyroidism in non dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome,so as to effectively prevent CKD-MBD.The main mechanism of its action may be closely related to the improvement of serum FGF23,FGFRs and Klotho protein levels. |
PDF Full Text Request