| Objective To observe the clinical efficacy and safety of Shengqing Jiangzhuo capsule on patients with chronic renal failure(CRF)based on ascending and descending theory of traditional Chinese medicine(TCM).Serum creatinine(Scr),urea nitrogen(BUN),24 hour urinary protein(24UPR),and plasma albumin(ALB),Changes of endogenous creatinine clearance rate(Ccr),serum connective tissue growth factor(CTGF)and hepatocyte growth factor(HGF)levels were measured in patients in laboratory,to discuss the possible mechanism of Shenqing Jiangzhuo capsule on delaying CRF renal fibrosis at cytokine level based on ascending and descending theory of TCM.Methods According to the design criteria,60 patients with chronic renal failure(CKD2-4)were randomly divided into two groups: control group(n=30)and treatment group(n=30).In the control group,Shenshuai Ning capsule was taken on the basis of routine treatment,and warm water was given 3 times a day,4-6 capsules per time before meals,while in the treatment group,Shengqingjiangzhuo capsule was added on the basis of routine treatment,and warm water before meal was given three times a day,3-4 tablets at a time.Taking 4 weeks as a course of treatment,the patients in both groups were actively treated for4 weeks.The serum creatinine(Scr),urea nitrogen(BUN),24 hour urine protein(24UPR)and plasma albumin(ALB)were recorded before and 28 days after treatment in each group of CRF patients.Endogenous creatinine clearance rate(Ccr)and changes of clinical symptoms were used to evaluate the clinical efficacy.Before treatment and on the 28 th day aftertreatment,the venous blood from the ventral elbow of the patients with CRF was centrifuged and the upper serum was collected.The hepatocyte growth factor(HGF)and the growth of connective tissue(CTGF)were detected by enzyme-linked immunosorbent assay(ELISA).To clarify the possible mechanism of Shengqingjiangzhuo capsule in treating chronic renal failure with renal fibrosis based on the ascending and descending theory.In the same time,25 healthy groups were selected as control,and the levels of CTGT and HGF were tested by the same method,and the levels of CTGT and HGF in the patients with CRF were compared.The data,statistics and analysis involved in this project are calculated and processed by the SPSS22.0 statistical software.Results1.Before entering clinical observation,the general data of each group,such as sex,age,course of disease and total scores of TCM symptoms were compared,showing that the baseline data were comparable(P>0.05).2.In the aspect of improving the symptoms of traditional Chinese medicine,and the treatment group's clinical efficacy was significantly better than another group before and after treatment,and there was significant difference between the two groups(P<0.01).The patients' clinical symptoms could be improved to different degrees by comparison between the two groups of CRF.3.The total effective rate was 70% in the CRF control group and 93.33% in the treatment group.Compared with the two groups,the total effective rate in the treatment group was obviously higher than another group(P<0.01).4.After treatment,the plasma albumin(ALB)level in both groups was significantly higher than before(P<0.01),but there was no obvious difference between them(P>0.05).The level of 24-hour urinary protein(24UPR)in the two groups of CRF was significantly lower than that before treatment(P<0.01),and the level of 24 UPR in the treatment group wasobviously lower than another group(P<0.01).5.Compared with pre-treatment,both CRF groups had significant effect on decreasing serum creatinine(Scr),urea nitrogen(BUN)level and increasing endogenous creatinine clearance rate(Ccr)(P<0.01).However,there was no significant difference in the reduction of urea nitrogen level between groups(P>0.05).On the aspect of reducing serum creatinine and increasing endogenous creatinine clearance rate,the therapeutic effect of the treatment group was significantly better than that of the control group(P<0.01).6.Before treatment,the serum CTGF level was higher and the serum HGF level was lower than that in the healthy group(P< 0.01),but there was no correlation between the serum HGF level and the serum CTGF level before the treatment(P>0.05).After treatment,the level of blood CTGF in each group of CRF was decreased and the level of blood HGF was increased,and the treatment group's clinical efficacy was significantly better than control group(P<0.01).There was no correlation between serum HGF and CTGF before treatment(P>0.05).There was a moderate positive correlation between the serum HGF level and Ccr before and after treatment,and a moderate negative correlation between the blood CTGF level and Ccr before and after treatment.There was no correlation between the level of CTGF and the quantity of 24-hour urinary protein(P>0.05).Conclusion1.Shengqing Jiangzhuo capsule can obviously improve the clinical symptoms and signs of patients with chronic renal failure due to deficiency of spleen-kidney-qi and dampness-turbidity and blood stasis.At the same time,Shengqing Jiangzhuo capsule can reduce urine protein(24UPR)and increase the level of plasma albumin(ALB).The effect of improving or protecting renal function is remarkable.2.Shengqing Jiangzhuo capsule can significantly reduce the level of serum creatinine(Scr),urea nitrogen(BUN)and increase endogenous creatinine clearance rate(Ccr),inpatients with chronic renal failure.The curative effect of Shengqing Jiangzhuo capsule is significantly better than that of the control group.3.Before treatment,the level of blood CTGF in all groups was significantly higher than that in healthy group,and the level of blood HGF was significantly lower than that in healthy group.There was no correlation between serum HGF level and serum CTGF level before treatment.4.Shengqing Jiangzhuo capsule could significantly reduce the level of serum CTGF and increase the level of serum HGF in the patients with chronic renal failure.Before and after treatment,the level of serum CTGF in all groups of CRF had a moderate negative correlation with Ccr(P<0.01),and the level of serum HGF had a moderate positive correlation with Ccr(P<0.01).It is suggested that Shengqing Jiangzhuo capsule may decrease the production and deposition of ECM by lowering the level of blood CTGF and increasing the level of blood HGF of the patients,thus delaying or preventing the progression of renal fibrosis. |
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