| ObjectiveBased on my tutor’s years of clinical experience and extensive literature review,the purpose of this project is to observe the effectivenss of Shenshuai prescription composed of the method of strengthening spleen-tonifying kidney-dispersing turbid-expelling blood stasis in Stage 2-4 CKD(with spleen and kidney qi deficiency combined with blood stasis and turbidity),as well as to to observe its influence on homocysteine.So as to investigate its role in reducing cardiovascular risk factors in patients with kidney disease and to provide new ideas and clinical demonstration for TCM treatment of CKD.MethodsAccording the request of randomized,controlled studies,this research enrolled 68 cases of CKD stage 2-4 with spleen and kidney qi deficiency combined with blood stasis and turbidity in Shenzhen Bao’ an Hospital of TCM from January 2019 to December 2020,and divided this 68 cases into treatment group and control group according to random number method,with 34 patients in each group.The control group received western medicine basic treatment,while the treatment group was given Western medicine basic treatment combined with Shenshuai prescription(composing with the formula of the method of strengthening spleen-tonifying kidney-dispersing turbid-expelling blood stasis).Both groups were treated for 8 weeks.Then the scores of TCM syndrome,renal function(Scr,BUN,Cys-C,β2-MG)and blood Hcy were recorded before and after treatment.The glomerular filtration rate(eGFR),TCM syndrome total score and total effective rate were calculated too.Meanwhile,safety indexes were detected.Finally,after statistical analysis,we evaluated the clinical effect of method of strengthening spleen-tonifying kidney-dispersing turbid-expelling blood stasis comprehensively and its’ influence on blood homocysteine.Results1.Two cases of the treatment group shed,so well as the control group.Finally,64 cases were included in the result analysis,in which 32 cases in the treatment group and 32 cases in the control group.2.Before treatment,there were no significant differences between the two groups in gender,age,stage of CKD and primary disease,and the two groups were comparable(P>0.05).3.In terms of renal function,Scr,BUN,Cys-C,β2-MG,eGFR had no significant difference between the two groups before treatment,which was comparable;After treatment,Scr,BUN,Cys-C and β2-MG in two groups were decreased in different degrees(P<0.05).Compared with the control group,the decreased of Scr,BUN,Cys-C,β2-MG were more significantly(P<0.05).At the same time,eGFR in both groups increased to different degrees(P<0.05);Compared with the control group,the increase of eGFR in the treatment group was more significant,the difference was significant(P<0.05).4.In the aspect of homocysteine,there was no significant difference in Hcy between the two groups before treatment(P>0.05).After treatment.Hcy in both groups decreased to different degrees(P<0.05).Compared with the control group,the Hcy decrease in the treatment group was more significant(P<0.05).At the same time,the Pearson correlation analysis showed that Hcy was positively correlated with Scr and negatively correlated with eGFR(r=0.610,-0.543)and after treatment,the SPear-man correlation analysis also showed that Hcy was positively correlated with Scr and negatively correlated with eGFR(r=0.551,-0.439).5.In terms of total TCM syndrome scores,the two groups had no significant difference in total TCM syndrome scores before treatment,which was comparable(P>0.05).After treatment,the total scores of TCM syndromes in both groups decreased to different degrees(P<0.05).In addition,compared with the control group,the decrease of TCM syndrome scores in the treatment group was more significant(P<0.05).The total effective rate of the treatment group was 87.5%,and that of the control group was 59.8%.The difference between the two groups was significant(P<0.05).6.In terms of the scores of major TCM syndromes,there was no significant difference between the two groups in fatigue,shortness of breath and lazy speech,lack of food and inactivity,waist and knee pain,nausea and vomiting,drowsiness of limbs,lumbago and somber complexion before treatment,which was comparable(P>0.05).After treatment,both groups showed different degrees of improvement in fatigue,lack of food and inactivity,drowsiness of limbs(P<0.05).In addition,compared with the control group,the decrease of fatigue and drowsiness of limbs in the treatment group was more significant(P<0.05)while there was no significant difference between the two groups in the syndromes of lack of food and inactivity(P>0.05).For shortness of breath and lazy speech,waist and knee pain,lumbago,the treatment group had different degrees of improvement(P<0.05),while the control group had no significant improvement(P>0.05),the difference was significant(P<0.05).For nausea and vomiting,somber complexion,the treatment group had different degrees of improvement(P<0.05),while the control group had no significant improvement(P>0.05),but there was no significant difference between the two groups(P>05).7.During the treatment period,no adverse events occurred in 64 patients,and no abnormal safety indicators were detected.ConclusionThe method of strengthening spleen-tonifying kidney-dispersing turbid-expelling blood stasis(Shenshuai prescription)can effectively improves kidney function,decreased Scr,BUN,Cys-C,β2-MG,rise eGFR,improve the clinical symptoms(especially in fatigue,shortness of breath and lazy speech,waist and knee pain,drowsiness of limbs,lumbago),as well as decreased homocysteine of patients in Stage 2-4 CKD(with spleen and kidney qi deficiency combined with blood stasis and turbidity).This method has certain efficacy in improving renal function,alleviating clinical symptoms and reducing cardiovascular risk factors(Hcy)in patients with kidney disease. |
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