Analysis Of Influence Factors And Gubenxiezhuo Therapy's Protective Effect On Chronic Kidney Disease Progression Based On 285 Cases

Objective:To analyze the factors that influence the progress of chronic kidney disease(CKD),the relationships between The Guben Xiezhuo therapy and the progress of renal functions.Based on these,we try to excavate Professor Li Ning's core prescriptions for the treatment of CKD and provide theoretical evidences for the clinical prevention of the disease.Methods:Retrospective cohort study was adopted.We selected 670 cases in all the patients(out-patients and in-patients)in Wangjing Hospital from January 1st,2014 to Dece,mber 31th,2016 who were eligible for CKD diagnostic criteria,and 285 cases were included lastly.Observations started from when patients were diagnosed and the baseline events,following-up events and endpoint events were recorded.Taking influential factors as covariates,survival time and endpoint events as dependent variables to analyze the model of Cox multiple stepwise regression in order to explore the factors that influence the progress of CKD;taking Chinese medicine with the function of Guben Xiezhuo as one of the influential factors and layering them into the equation according to the courses,and then observe the effect of Guben Xiezhuo dialectical method in delaying the progress of CKD and reducing the occurrence of endpoint events.Using the software Liquorice combined with homogeneous networkto create data and import all the prescriptions that Professor Zhang Ning prescript for patients,and then find the compatibility relationships between the medicines.Finally the core prescr:iptions were identified after Professor made sure.Results:1.Baseline characteristics:285 cases were included and average baseline age was 68.98,with 51.6%of males.And the median following-up was 230 days,baseline CKD stages were 41.7%of patients for CKD ?,19.3%for CKD ?,16%for CKD ?,14%forty,8.8%for ?,and 77.2%for CKD ?-?.2.Endpoint events:There were 57 cases endpoint events,and 31 cases were main endpoints events which included 19 cases of death,6 cases of renal replacement treatment and 6 cases of entering CKD VI.Secondary endpoints events were 26 cases,which included 10 cases of 25%decrease of eGFR compared with baseline and changes of GFR stages,16 cases of ACR stages progress.CKD rapid progress was not observed.3.Analysis results about the Cox regression of total endpoints events:Results based on single factors analysis:risks factors for all endpoints events were age,hyperphosphatemia,hyponatremia,anemia,AKI,non-AKIAKD,and protective factor was Guben Xiezhuo therapy.Factors that still exert significant influence in multiple analyses were hyperphosphatemia and non-AKI AKD based on CKD.Classifying the treatment courses and draw survival carve and the results showed that the courses of treatment affect short-term and long-term survival time of patients.The survival time of medicine non-taking patients were shorter than medicine taking patients.As to the different stages of medicine taking patients there was no significant difference in short-term survival time.However as to the long-term survival time,survival curves of the patients who take medicine half or more than half years was straight and higher than patients in other courses obviously.4.Analysis results about the Cox regression of main endpoint events(death,renal replacement treatment,entering CKD stages):Results based on single factors analysis:risks factors for main endpoints events were baseline CKD stages,anemia,hyperphosphatemia,hyponatremia,AKI,,non-AKI AKD,protective factor was still Guben Xiezhuo therapy but without obvious significance.Influential factors in multiple factors analysis were hyperphosphatemia,non-AKI AKD based on CKD.5.The core prescriptions that Professor Zhang Ning prescribed for CKD treatment based on the analysis of complex network were:Astragalus mongholicus,Radix bupleuri,Pyrrosia lingua,Cogongrass,Pachyma cocos,Radix salviae miltiorrhizae,Semen Coicis,Angelica sinensis,Lumbricus,Paeonia lactiflora pallas,Wild jujube,Prepared Radix et Rhizoma Rhei with wine.Conclusion:1.Hyperphosphatemia and non-AKI AKD based on CKD are independent risk factors in progress of CKD course.2.Guben Xiezhuo therapy can delay the progress of CKD course in some extent.3.It is benefit to summarize and inherit the thought of professor Zhang Ning in CKD treatment based on the analysis of complex network.