Effect Of Rong Huang Granules On The Serum SOST、β-catenin Of Non Dialysis CKD-MBD Patients With Kindney Deficiency Damp Heat Syndrome

Objective: In this study,Ronghuang granules were used to observe the expression of osteosclerosis protein(SOST),β-catenin(β-catenin)before and after treatment of patients with chronic kidney disease with mineral and bone metabolism abnormalities(CKD-MBD)and non-dialysis kidney deficiency and damp heat syndrome.Changes in TCM syndrome scores,renal function,and traditional bone metabolism indicators,it is initially clear whether Ronghuang Granules can delay CKD-MBD by mediating bone metabolism by mediating Wnt / β-catenin signaling pathway.Methods: Sixty-seven non-dialyzed CKD-MBD patients with kidney deficiency and dampness-heat syndrome meeting the inclusion criteria were randomly divided into a treatment group of 34 cases and a control group of 33 cases.During the study,7 patients fell off,and the treatment group and control group each completed 30 cases.Another 10 healthy people who were selected for the same physical examination at random were selected as the normal group.The control group received basic western medicine combined with Chinese medicine enema adjuvant therapy;the treatment group received Ronghuang granules based on the treatment of the control group;the course of treatment was 12 weeks,at the 4th weekend,the 8th weekend,and the 12 th weekend.Record the TCM syndrome scores before and after treatment in the two groups of patients;collect laboratory indicators before and after treatment in the two groups of patients,such as serum creatinine(Scr),urea nitrogen(BUN),estimated glomerular filtration rate(e GFR),calcium(Ca),Phosphorus(P),and parathyroid hormone(i PTH)levels,etc;the blood SOST and β-catenin protein concentrations in normal,control,and treatment groups were measured,and adverse reactions were observed during the study.Recorded in the table.Finally,the experimental data was sorted and summarized,and the research results were comprehensively analyzed using SPASS 21.0 statistical software and Graph Pad Prism 6.0 mapping software.Result:(1)Comparing the CKD-MBD effect and renal function effect of the two groups,the treatment group was superior to the control group(P<0.05 or P<0.01);at the end of the 4th week,there was no statistical difference between the treatment group and the control group;at the end of the 8th and 12 th week,the treatment group was superior to the control group(P<0.01).(2)Compared with the two groups before and after treatment,there was no significant difference between the two groups(P > 0.05);but there was significant difference between the two groups(P<0.01);the integral value of the four weeks,eight weeks and 12 weeks in the treatment group was significantly lower than that before treatment(P<0.01);the integral value of the eight weeks in the treatment group was significantly lower than that before treatment(P<0.01)Compared with the control group at the same time,there was a significant difference in the decrease of syndrome integral value at the end of 12 weeks(P<0.01).(3)Compared with before treatment,the renal function indexes in the control group were improved only at the end of 12 weeks after treatment,with significant statistical difference(P<0.01);the serum BUN in the treatment group was significantly decreased at the end of 8 weeks(P<0.05),and the serum BUN,SCR,EGFR at the end of 12 weeks were significantly different(P<0.05 or P<0.01).(4)In the control group,there were significant differences in serum Ca,i PTH(P<0.05)and in serum Ca,P,i PTH(P<0.05 or P<0.01)at the end of 8 weeks and 12 weeks respectively;in the treatment group,there were significant differences in serum Ca,P,i PTH(P<0.05 or P<0.01)at the end of4 weeks and 8 weeks and 12 weeks respectively The improvement of serum Ca and P in the treatment group at the end of 12 weeks was significantly different from that in the control group(P<0.05 or P<0.01).(5)Before the treatment,the levels of serum SOST and β-catenin in the control group and the treatment group were significantly higher than those in the normal group(P<0.01),but there was no difference between the two groups(P>0.05);There was no statistical difference in the level of blood SOST andβ-catenin in the control group before and after treatment.The level of blood SOST andβ-catenin in the treatment group was significantly lower than that before treatment(P<0.01);the improvement of blood SOST and β-catenin in the treatment group was statistically different from that in the control group at the same time(P<0.05 or P<0.01).Conclusion: Ronghuang granules can reduce TCM syndrome scores and improve serum BUN,Scr,e GFR levels in patients with non-dialysis CKD-MBD kidney deficiency and damp heat syndrome,and alleviate clinical symptoms and improve patients’ quality of life.Secondly,Ronghuang granules can improve blood calcium,phosphorus,Inhibiting SHPT,adjusting the balance between Ca,P and i PTH,and the effect is better with the course of treatment,indicating that this formula has a better therapeutic effect on CKD-MBD,and presents a certain course-effect relationship.Ronghuang granules can down-regulate the expression of SOST and β-catenin in the serum of patients with CKD-MBD,and may participate in the regulation mechanism of bone metabolism disorders by mediating the Wnt/β-catenin signaling pathway,thereby delaying the progress of CKD-MBD.In addition,the levels of blood SOST andβ-catenin in patients with CKD-MBD are higher than those in the normal population.It is speculated that abnormal activation of the Wnt/β-catenin signaling pathway has led to the occurrence and development of CKD-MBD.The specific mechanism needs to be further confirmed.