Effect Of Yougui Pill On Maintenance Hemodialysis Patients Suffering Chronic Kidney Disease-Mineral And Bone Metabolism Disorders With Traditional Chinese Medicine Type Of Deficiency In Spleen And Kidney

objectiveTo investigate the efficacy of yougui pill in Chronic Kidney disease-mineral and Bone metabolism Disorder(CKD-MBD)with Traditional Chinee Medicine(TCM)type of deficiency in spleen and kidney.MethodsEighty-nine MHD patients whose TCM type belongs to the type of deficiency in spleen and kidney were enrolled,and randomly divided into two groups,treatment group(Group A,n=45 cases)and control groups(Group B,n=44 cases)according to the random number table method.Apart from regular CKD-MBD medicines,such as lanthanum carbonate,calcitriol and calcimimetics,group A received Yougui pills,a traditional Chinese medicine,for 12 weeks with 1 pill per time,three times per day.Group B received conventional western treatments,including regular medicines and dialysis.Several laboratory index,such as serum kalium,calcium,phosphorus,parathyroid hormone,and bone metabolic indices(total 25(OH)D,?-CTX,N-MID),bone mineral density,liver function were tested in all enrolled patients before and after 12 weeks treatment,TCM syndrome score was also evaluated before and after 12 weeks treatments.ResultsIn group A,after 12 weeks treatments,both serum phosphorus and parathyroid hormone decreased.The serum ?-CTX were decreased and the level of N-MID osteocalcin were increased,the differences were statistically significant(p<0.05).For indicator about bone mineral density,the T and Z values also increased,the differences were statistically significant(p<0.05).Compared with group B,the TCM syndrome score improved significantly in group A(p<0.05).But there were no significant difference in the serum kalium,calcium,liver function and serum total 25(OH)vitamin D levels(p >0.05).Two of the forty-five patients presented diarrhea during the treatment,but were cured by supportive treatment.In group B,after12 weeks of treatments,serum phosphorus and parathyroid hormone were decreased,meanwhile the T and Z values of bone mineral density index were increased.Statistically the differences were significant(p<0.05).The serum ?-CTX were decreased and the level of N-MID osteocalcin were increased,but the differences were not statistically significant(p=0.19,p=0.09 respectively),and there was no significant improvement in TCM syndrome score(p=0.10).ConclusionsOn the basis of conventional western medicine for treating CKD-MBD,the addition of yougui pill can not only effectively improve the TCM syndromes,but also improve hyperphosphatemia,secondary hyperparathyroidism of CKD-MBD,and the serum levels of N-MID osteocalcin and ?-CTX,and its treatment is safe and effective.