Clinical Study On The Effect Of Bushen Huoxue Method On Bone Metabolism And Oxidative Stress Of CKD-MBD

ObjectiveTo detect and compare the changes of calcium(Ca),phosphorus(P),parathyroid hormone(PTH),bone specific alkaline phosphatase(BAP),advanced oxidation protein product(AOPP),malondialdehyde(MDA),superoxide dismutase(SOD)and other indicators in CKD-MBD patients at stage 4-5 before and after treatment with Bushen Huoxue Method,so as to explore the effect of Bushen Huoxue Method on bone metabolism and oxidative stress of CKD-MBD patients.At the same time,through the evaluation of TCM syndrome score and safety index,further evaluate the efficacy and safety of Bushen Huoxue Method,and finally provide new ideas and methods for the treatment of CKD-MBD.MethodsFrom June 2019 to December 2020,76 cases of non dialytic CKD(stage 4-5)-MBD patients with kidney deficiency and blood stasis syndrome were randomly divided into control group(38 cases)and Bushen Huoxue group(38 cases).The control group was given basic Western medicine treatment,such as supplementing active vitamin D,reducing phosphorus,controlling blood pressure and blood glucose,correcting anemia,and so on.In Bushen Huoxue group,Bushen Huoxue decoction was added on the basis of Western medicine.The course of treatment was 8 weeks.After sorting out the data,spss24.0 software was used to count and analyze the differences in laboratory indexes and TCM syndrome scores between the two groups before and after treatment,and the curative effect was evaluated systematically.Results1.Bone metabolism index:Compared with those before treatment,both groups could significantly increase blood Ca(P<0.01),reduce P and PTH(P<0.01).As for BAP,the control group had no significant effect(P>0.05),while the Bushen Huoxue group could significantly reduce BAP(P<0.01).Compared with the control group,the Bushen Huoxue group was significantly better in the improvement of Ca,P,PTH and BAP(P<0.01).The improvement effect of Bushen Huoxue group on bone metabolism disorder was stronger than that of the control group.2.Oxidative stress index:Compared with those before treatment,AOPP and MDA in Bushen Huoxue group decreased significantly(P<0.01),and SOD increased significantly(P<0.01),but there was no significant difference in the control group(P>0.05).Compared with the control group,AOPP,MDA and SOD improved significantly in Bushen Huoxue group(P<0.01).Bushen Huoxue group has more advantages in improving oxidative stress than the control group.3.Renal function index:Compared with those before treatment,Scr and BUN in both groups were significantly decreased(P<0.01).Compared with the control group,Scr and BUN were better in Bushen Huoxue group.The method of invigorating kidney and activating blood circulation combined with basic treatment of Western medicine has better protective effect on renal function.4.TCM syndrome score and curative effect:Compared with that before treatment,the TCM syndrome score of the two groups decreased significantly(P<0.01).Compared with the control group,the effect of Bushen Huoxue group was stronger(P<0.01).The total effective rate of Bushen Huoxue group after treatment was 89.47%,which was significantly higher than that of the control group(65.78%),with a significant difference(P<0.05).The Bushen Huoxue group was better than the control group in improving the clinical symptoms.5.Safety index:There was no significant difference in ALT and AST between the two groups before and after treatment(P>0.05),which suggested that the Bushen Huoxue method was safe in the treatment of CKD-MBD patients.Conclusion1.Bushen Huoxue method can effectively regulate the disorder of bone metabolism and improve oxidative stress in CKD-MBD patients.2.Bushen Huoxue Method combined with western medicine basic treatment can effectively reduce the TCM syndrome score of CKD-MBD patients,improve clinical symptoms and protect renal function.3.Bushen Huoxue Method is safe and can be used in the treatment of CKD-MBD patients.