| Objective: By observing the Shiweiqihuangyishen decoction on chronic renal failure of spleen and kidney deficiency with blood stasis and turbidity syndrome patients before and after treatment for the changes of serum creatinine, urea nitrogen, Cystatin C,estimated glomerular filtration rate changes and TCM syndromes integral, to understand the clinical curative effect of the prescription on CRF patients.Methods: Selected 68 cases of CRF of spleen and kidney deficiency with blood stasis and turbidity syndrome patients. According to the random number Tab.le were randomly divided into treatment group and control group, each group of 34 cases. In the course of follow-up treatment, 8 cases were excluded, 4 cases were from reatment group,4 cases were from control group. The actual completion of 60 cases, 30 cases of the control group, the treatment group of 30 cases. Both of the two groups were given the basic treatment of Western medicine, in the treatment group on the basis of Western medicine treatment plus Shiweiqihuangyishen decoction, the control group on the basis of Western medicine treatment plus Niaoduqing particles. 8 weeks for 1 courses of treatment, a total of 1 courses of treatment were observed. Before treatment and after treatment respectively to detect patients with Scr, BUN, Cys C and GFR, contrast the above four index change in before and after treatment. At the same time, the changes of TCM syndrome integral values were observed before and after treatment.Results:1 Comparison of TCM Syndrome efficacy: In the treatment group, the total effective rate was 93.3%, the control group was 60%, and there was significant difference between the two groups(P<0.01);2 TCM syndrome integral comparison: There was no significant difference between the two groups before treatment(P>0.05); After treatment, the TCM syndrome score of treatment group was significantly lower than before treatment(P<0.01), the control group after treatment, TCM syndrome score lower than before treatment(P<0.05), the difference between the two groups(P<0.05);3 Comparison of clinical curative effect: The total effective rate of treatment group was90%, the control group was 63.3%, the treatment group was significantly better than the control group(P<0.01);4 Comparison of laboratory indexes:(1)Before treatment, the two groups of patients with Scr, BUN, Cys C, e GFR were not statistically significant(P>0.05);(2)After treatment, the level of Scr in treatment group was significantly lower than that before treatment(P<0.01), and there were differences in the level of Scr between the control group and the treatment group(P<0.05); The difference between the two groups before and after treatment was significantly different(P<0.01);(3)Treatment group and control group after treatment BUN levels were significantly lower than that before treatment(P<0.01), there are differences between the comparison between the two groups before and after treatment difference(P<0.05);(4)Treatment group after treatment Cys C levels were significantly lower than before treatment(P<0.01), the control group after treatment, there are differences between the Cys C level compared with before treatment(P<0.05).Differences between the two groups are significant differences(P<0.01).(5)Treatment group e GFR levels after treatment compared with before treatment with significant difference(P<0.01).The control group after treatment of e GFR levels higher than before treatment(P<0.05).The difference between the two groups to compare difference(P<0.05).Conclusion: Shiweiqihuangyishen decoction can improve the clinical symptoms of chronic renal failure of spleen and kidney deficiency with blood stasis and turbidity syndrome patients reduce serum SCR, Bun, Cys C and improve renal function of patients; Patients taking the prescription did not appear obvious adverse drug reactions,before and after the treatment of safety indicators showed no abnormal changes,indicating that the prescription in the clinical use of high safety.Objective: By adenine intragastric administration of replication in CRF rats. Through the observation of the groups of rats with SCR, BUN, 24 h Upro, 24 h urine volume and renal pathological morphology, renal TGF-?1,HGF,?-SMA and FN protein expression,to observe the effect of Shiweiqihuangyishen Decoction on the CRF model rats, and explore its action mechanism.Methods:(1)The modeling and grouping: Basis weight according to the random number Tab.le 60 rats take 15 as the normal group, the remaining 45 production model. In the normal group, the same amount of distilled water was used to fill the stomach, and the remaining 45 rats were filled with adenine for 28 days. In the process of modeling, 2rats died, and 43 of the models were successfully created. The successful model rats were divided into three groups according to the above methods: model control group, 13 rats, 15 rats in the Valsartan group, Shiweiqihuangyishen Decoction group, 15 rats.(2)Therapeutic administration: Normal group and model group were given equal volume of distilled water to fill the stomach; Yishen Decoction group prescription decoction was concentrated in a water bath to 2.4 kg crude drug/L of water decoction,according to the weight of 24 g crude drug/kg- D rats intragastrically, once a day, 2ml /gavage; The Valsartan group will be Valsartan Capsules soluble in warm water,according to the D 20mg/kg perfusion stomach, a total of 8 weeks of treatment.(3)Index detection: After the treatment, the blood of rats was collected, and the serum creatinine and urea nitrogen were detected; Take the rat 24 h urine, detection of 24 h urinary protein quantitation, measurement of 24 h urine volume. The rats were sacrificed and the removal of both kidneys. The renal tissues were observed and pathological changes of renal tissue were observed by HE, Masson staining; The expression of TGF-?1,HGF,?-SMA and FN protein in renal tissues were detected by immunohistochemistry.(1)General state: After the model was built to the end, control group rats because of poor performance status, a poor diet, polydipsia polyuria, chills like to get together, the hair color is dull, the tail is cold and wet, do not like activities and other symptoms.After 8 weeks of treatment, the treatment of valsartan group and the Yishen Decoction group of the above phenomenon were improved, in which the general state of the Yishen Decoction group than the Valsartan group improved more significantly.(2)Laboratory index: After the model was completed, the Scr, BUN, 24 h Upro and 24 h urine volume of the rats in the model group were significantly higher than that of the normal rats. After 8 weeks of treatment, compared with the normal group, the control group Scr, BUN, 24 h Upro, 24 h urine volume increase(P<0.01); Compared with the control group, the indexes of each treatment group were significantly improved(P<0.01); Compared to the treatment group, the improvement of the above mentioned indexes of the kidney benefiting group was better than that of the Valsartan group(P<0.05).(3)Renal pathological changes: In normal group, there was no pathological change in kidney tissue. The model control group had severe impairment of renal tubular,glomerular and interstitial; The renal pathological damage in each treatment group was significantly reduced compared with the model control group, which was better than the Valsartan group.(4)Immunohistochemical method: The expression of TGF-?1,?-SMA,FN and HGF in normal kidney tissue was not expressed in normal group; Compared with the normal group, the expression of the four indexes in the model control group was significantly increased, and there was significant difference(P<0.01); The expression of TGF-?1,?-SMA and FN in each treatment group were significantly lower than that in model control group(P<0.01). The expression of HGF in each treatment group was significantly higher than that in the model group(P<0.01); Comparison between treatment group and Yishen Decoction group the expression level of TGF-?1,?-SMA and FN is lower than that of valsartan group(P<0.05), the expression of HGF was Results: higher than that of valsartan group(P<0.05).Conclusion:(1)Shiweiqihuangyishen Decoction can improve the general condition of CRF model rats, significantly improve the symptoms of rats, reduce the level of Scr, BUN, 24 h Upro,protect renal function;(2)Shiweiqihuangyishen Decoction can reduce the pathological damage of kidney in rats and reduce the renal tubular expansion, atrophy and glomerular sclerosis,inflammatory cell infiltration, cell proliferation and so on.(3) Shiweiqihuangyishen Decoction can improve renal fibrosis in rats, reduce important molecular ?-SMA and FN protein expression in the process of renal fibrosis, reduce Pro fibrogenic cytokine TGF-?1 in renal tissue expression and increased expression of anti fibrosis factor HGF, so as to improve the progress of renal fibrosis. |
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