| Objective: Observing the clinical effect of Supplemented Shenling Baizhu Powder on patients suffering from continuous ambulatory peritoneal dialysis(CAPD)syndrome,which is characterized by spleen deficiency and blood stasis,a gastrointestinal symptom score scale,hormone levels,and intestinal flora were all taken into account.Investigating the influence and process of Supplemented Shenling Baizhu Powder on the digestive system and intestinal flora of those with CAPD syndrome,which is characterized by spleen deficiency and blood stagnation.After 12 weeks,the changes of TCM syndrome score and gastrointestinal symptom score scale were analyzed.Gastrointestinal peptide hormones Pepsinogen I(PGI),Pepsinogen II(PGII),Gastrin-17(G-17),Motilin(Motilin),and Gastrin-17 were compared between the two groups.MTL),Cholecystokinin(CCK),Somatostatin(SS),Vasoactive intestinal peptide(Vasoactive intestinal peptide,VIP),Pancreatic polypeptide(PP),Leptin(Lep)and serum Albumin(ALB).Methods: 1.Randomly dividing ninety-two eligible patients with CAPD due to spleen deficiency and blood stasis into two groups of 46 each,3 were discharged during the treatment in each group,with a total of 86 cases actually completed.Both groups were given CAPD+ Western medicine basic treatment(regulating blood pressure,correcting anemia,regulating electrolyte balance and calcium and phosphorus metabolism,etc.).The control group was administered Clostridium typhimurium diphtheriae capsules,while the treatment group was given Supplemented Shenling Baizhu Powder(1 dose daily,split into morning and evening).After 12 weeks,the changes of TCM syndrome score and gastrointestinal symptom scale in the two groups were analyzed.To compare the differences in gastrointestinal peptide hormones PG I,PGII,G-17,MTL,CCK,SS,VIP,PP and nutritional indicators Lep and ALB between the two groups.2.Randomly select 30 patients in the treatment group,and select 10 health examiners from the physical examination center,keep the excrement of the examiners and 30 patients before and after treatment,strictly implement aseptic operation in the process of excrement,use a sterile spoon to take fresh samples from the inside,about 1-2 g from the middle and back,and store them in a sterile frozen tube after sampling,and store them in an ultra-low temperature refrigerator at-80 ℃,and use 16 S r DNA sequencing analysis.The changes of intestinal flora of patients were observed.Results:1.Comparison of the efficacy of TCM symptoms and symptoms points: After 12 weeks of treatment,the efficacy of TCM symptoms in the treatment group was found to be superior to that of the control group(P<0.05).Both groups experienced a decrease in TCM symptom scores(P<0.05),with the treatment group’s score notably lower than the control group’s(P<0.05).2.Comparison of serum gastrointestinal hormone levels: No significant difference in serum gastrointestinal hormone levels was observed between the two groups of patients prior to treatment(P>0.05).After 12 weeks of treatment,the serum levels of PG I,PG II,G-17,MTL,PP,CCK,and VIP in the treatment group were lower than those before treatment and the control group,with the serum SS level increasing(P<0.05).Additionally,no significant difference in gastrointestinal hormone levels between the control group and before treatment was observed(P>0.05).3.Comparison of nutritional indicators: No noteworthy divergence in serum Leptin and ALB concentrations was observed between the two groups prior to treatment(P>0.05).Following 12 weeks of therapy,serum ALB was augmented and serum Leptin was lower in the treatment group than before treatment(P<0.05).The serum ALB of the control group was augmented compared to before treatment(P<0.05),and serum Leptin level had no noteworthy alteration compared to before treatment(P>0.05).4.Analysis of intestinal microflora: Analysis of intestinal microflora: At the phylum level,compared with healthy patients,CAPD patients had decreased abundance of Phylum Firmicutes and Phylum Bacteroidetes,and increased abundance of Phylum Verrucomicrobia,Phylum Actinomycetes,and Phylum Proteobacteria;after treatment,the abundance of Phylum Verrucomicrobia,Phylum Actinomycetes,and Phylum Proteobacteria decreased,and the abundance of Phylum Firmicutes and Phylum Bacteroidetes increased.At the genus classification level,the abundance of beneficial genera such as Bifidobacterium and Lachnospiracea decreased,and the abundance of pathogenic genera such as Escherichia/Shigella and Clostridium increased in CAPD patients compared with healthy individuals.After treatment,the abundance of beneficial genera such as Bifidobacterium and Lachnospiracea increased,and the abundance of pathogenic genera such as Escherichia/Shigella and Clostridium decreased.5.Diversity analysis of intestinal flora:Compared with healthy individuals,Alpha diversity Chao1 index,ACE index,and Shannon index were reduced in CAPD patients;Alpha diversity index Chao1 index,and ACE index were increased after treatment(P<0.05),and Shannon index was increased,with no statistically significant difference(P>0.05).Beta diversity was analyzed and there were significant differences in the colony composition of the three groups.Conclusion:1.Supplemented Shenling Baizhu Powder can reduce the TCM syndrome score and improve the TCM syndrome efficacy in patients with CAPD with spleen deficiency and stagnation.2.Supplemented Shenling Baizhu Powder can reduce the GSRS score and alleviate gastrointestinal symptoms in patients with spleen deficiency and stagnation evidence of CAPD.3.Supplemented Shenling Baizhu Powder can reduce the levels of serum PG I,PG II,G-17,MTL,PP,CCK,VIP,leptin,increase the levels of serum SS and ALB,and improve the gastrointestinal function and nutritional status of CAPD patients with spleen deficiency and blood stasis.4.Supplemented Shenling Baizhu Powder which can augment the diversity of bacterial communities,augment beneficial bacteria,diminish pathogenic bacteria,and control intestinal flora imbalance. |
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