| Objective:Observation of Ronghuang Granules on the clinical symptoms,laboratory examinations and serum secreted protein Dickkopf-1(DKK1)and secreted glycoprotein-3a(Wnt3a),analyze the clinical efficacy of Ronghuang Granules in the treatment of CKD-MBD,explore its molecular mechanism in the treatment of CKD-MBD from the perspective of Wnt/β-catenin signaling pathway regulation,and provide further evidence for evaluating Ronghuang Granules in the treatment of CKD-MBD.Methods:63 non-dialysis CKD-MBD patients with kidney deficiency and damp-heat syndrome were randomly divided into two groups according to the random number table method,including 31 cases in the control group and 32 cases in the treatment group.In addition,20 healthy people were ran domly selected as the normal group.Both groups of patients were given conventional Western medicine treatment,and the treatment group was treated with Ronghuang Granules on this basis.Serum creatinine(Scr),urea nitrogen(BUN),calcium(Ca),phosphorus(P),Parathyroid hormone(iPTH),DKK1,Wnt3 a,TCM syndrome score changeswere observed in the two groups,and estimate glomerular filtration rate(eGFR).The course of treatment for both groups was12 weeks.In the normal group,only serum DKK1 and Wnt3 a were detected.Result:(1)Disease efficacy:After treatment,the results of CKD-MBD curative effect and renal function curative effect showed that the curative effect of the treatment group was significantly higher than that of the control group(P<0.05 or P<0.01).Compared with the control group,the TCM syndrome curative effect treatment group had no statistically significant difference at the 4th week of treatment(P>0.05),and the difference was statistically significant at the 8th week of treatment and the 12 th week of treatment(P<0.05 or P<0.01),The treatment group is the best.(2)TCM syndrome integral value:There was no statistical difference in the scores of TCM syndromes between the two groups before treatment(P>0.05).Compared with before treatment,there was no statistically significant difference in the control group at the end of the 4th week of treatment,and the difference between the 8th and 12 th weekends of the treatment was statistically significant(P<0.05 or P<0.01).Compared with the treatment group before treatment,the scores of TCM syndromes in 4,8 and 12 weeks were significantly lower than before(P<0.05 or P<0.01).Comparing the decrease of TCM syndrome scores between the two groups at the same time,there was no statistically significant difference in the 4 weeks of treatment(P>0.05),and there were statistical differences in the 8 and 12 weeks of treatment(P<0.05 or P<0.01).The group decline is large.(3)Scr 、 eGFR 、 BUN:Serum Scr,BUN,and eGFR were relatively different in patients with patients before treatment(P>0.05).Compared with before treatment,the control group had no difference in serum Scr and eGFR treatment at 4and 8 weekends(P>0.05),and there were significant differences at 12 weekends of treatment(P<0.05);There were significant differences in serum BUN treatment at 4,8and 12 weekends(P<0.05 or P<0.01).Compared with the treatment group before treatment,serum Scr,eGFR and BUN had statistically significant differences at the 4,8and 12 weekends of treatment(P<0.05 or P<0.01).Comparing the renal function indexes of the two groups at the same time,serum Scr,eGFR,and BUN had no difference at the 4 and 8 weekends of treatment(P>0.05),and the treatment group was significantly better than the control group at the 12 th week of treatment(P<0.05).(4)Serum Ca,P,iPTH:There was no significant difference in serum Ca,P,iPTH between the two groups of patients before treatment(P>0.05).Compared with before treatment,serum Ca and iPTH in the control group were not statistically different after 4 weeks of treatment(P>0.05),and both were statistically significant at 8 and 12weeks(P<0.05 or P<0.01);Serum P was statistically significant at 4,8 and 12 weekends of treatment(P<0.05 or P<0.01).Serum Ca,P and iPTH of the treatment group were statistically significant at the 4,8 and 12 weekends of treatment compared with those before treatment(P<0.05 or P<0.01).Serum Ca and P of the treatment group compared with the control group at the same time,there was no difference in the 4 weeks of treatment(P>0.05),and the treatment group was significantly better than the control group at the 8 and 12 weeks of treatment(P<0.05 or P<0.01);Serum iPTH in the treatment group compared with the control group at the same time had no difference at the 4th and 8th week of treatment(P>0.05),and there was a significant difference at the12 th week of treatment.The treatment group was superior(P<0.05).(5)Serum DKK1,Wnt3a:Compared with the normal group,the expressions of serum DKK1 and Wnt3 a in the two groups were significantly increased(P<0.05).There was no significant difference in the expression of serum DKK1 and Wnt3 a between the two groups of patients before treatment(P>0.05).There was no significant difference in serum DKK1 and Wnt3a expression between the control group and before treatment(P>0.05),and the serum DKK1 and Wnt3 a expression in the treatment group were significantly different from before treatment(P<0.05).Comparing the two groups of patients after treatment,the treatment group was better than the control group(P<0.05 or P<0.01).Conclusion:(1)Ronghuang Granules can significantly improve the TCM syndromes and reduce the TCM syndrome integral value in the treatment of non-dialysis CKD-MBD patients with kidney deficiency and damp-heat syndrome.(2)Ronghuang Granules has obvious clinical effects in the treatment of non-dialysis CKD-MBD patients with kidney deficiency and damp-heat syndrome.It can effectively improve renal function,significantly reduce serum BUN and Scr levels,and increase eGFR;It can adjust the level of calcium and phosphorus,and significantly inhibit secondary hyperparathyroidism.(3)The mechanism of Ronghuang Granules to improve the condition of CKD-MBD patients may be through down-regulation of Wnt3 a protein expression and up-regulation of DKK1 protein expression to inhibit the abnormal activation of Wnt/β-catenin signaling pathway,thereby controlling the condition. |
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