Observation Of The Clinical Efficacy Of Renal Activation Blood Dampening Turbidity In The Treatment Of Non-dialysis Patients With Stage CKD4-5 With Calcium And Phosphorus Metabolism Disorder

Purpose:1.It is treated by kidney nourishing and blood,moisturizing turbidity.The clinical study of CKD4-5 with calcium and phosphorus metabolic disorder confirmed the effectiveness and safety of this method,and further explored the treatment principles and medication characteristics to provide a basis for clinical application.2.Through the treatment of kidney failure.To study the network pharmacology of CKD with calcium and phosphorus metabolism disorder,and to explore the mechanism of kidney nourishing and blood,moisturizing turbidity in the treatment of CKD4-5 with calcium and phosphorus metabolism disorder.Methods:Clinical observation: The patients selected in this study were outpatients and inpatients in the Department of Nephrology of the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine from December 2020 to December 2021.A total of 76 patients who met the criteria set in this study were randomly divided into two groups: the control group and the treatment group.On the basis of symptomatic treatment of western medicine,the control group was treated with calcitriol,and the treatment group was treated with traditional Chinese medicine decoction on the basis of the control group,which was based on Shenshuaifang,and observed for 12 weeks.Finally,70 patients were enrolled,35 in the control group and 35 in the treatment group.Ca,P,PTH,ALT,BUN,Scr,UA,24 h Pro,TCM syndrome integral values were recorded and GFR was calculated before and after treatment.SPSS26.0 statistical software was used to analyze and compare the differences within and between the two groups before and after treatment.Network pharmacology: through TCMSP,Swiss platform and literature search to obtain the active ingredients and targets of "Renal Failure Prescription".Human targets were screened and names were standardized using Unipro.The potential targets of CKD-MBD and calcium and phosphorus metabolic disorder were obtained from Gene Cards,OMIM,TTD and Drug Bank databases,and the associated target genes of drugs contained in renal failure prescription and CDK with calcium and phosphorus metabolic disorder were found out through Wayne diagram.Cytoscape 3.9.1,String database and Mate scape online database were used to construct drug-active ingredient-target network,construct PPI network diagram and analyzeGO and KEGG enrichment.Results:Clinical observation: 1.Laboratory indicators The differences of BUN,Scr,GFR,UA,Ca,P,24 h Pro,PTH and ALP between the control group and the treatment group after treatment were statistically significant(P < 0.05),indicating that the improvement of laboratory indicators in the treatment group was better than that in the control group.2.Symptoms and curative effect of traditional Chinese medicine The total effective rate of the control group was 62.86%.The total effective rate of the treatment group was 88.57%,and the difference was statistically significant.The treatment group is superior to the control group in the improvement of TCM symptoms;3.Overall clinical efficacy The total effective rate was 62.85% in the control group and 82.86% in the treatment group,the difference was statistically significant,indicating that the treatment group had more advantages than the control group in clinical efficacy;4.Security analysis During the treatment,the safety indicators of the two groups of subjects,including blood,urine routine,liver function and so on,were not significantly abnormal,and the patients did not complain of adverse reactions,indicating that the treatment was safe and feasible.Network pharmacology: After screening,151 active ingredients and 312 drug targets were obtained,and 124 targets related to kidney failure prescription in the treatment of CKD-MBD with calcium and phosphorus metabolic disorders were obtained after intersection with 787 disease targets,in which the key active ingredients included quercetin,kaempferol,etc.PPI network has 124 nodes and 2176 edges,and 18 key targets were screened out,including AKT1,TNF,IL6,TP53,CASP3,JUN,ESR1,IL1 B,EGFR,MAPK3,PPARG,STAT3,etc.1 979 entries were enriched by GO analysis,of which 1 686 entries had FDR <0.01,which were mainly involved in biological processes such as anti-oxidative stress,regulation of apoptosis,response to inflammation,and negative regulation of phosphate metabolism.KEGG pathway was enriched for 200 genes,most of which were enriched in cancer pathway,AGE-RAGE pathway,chemical carcinogen-receptor activation pathway and so on.Conclusion:Clinical observation: The therapy of Bushen Huoxue Lishi Huazhuo not only can decrease BUN,Scr,GFR,UA,Ca,P,24 h Pro,PTH,ALT and increaseGFR,but also can improve the clinical sign and symptom induced by CKD and calcium-phosphorus metabolism.So that the quality of life of patients can be improved,and less adverse reactions,safe and feasible,is an effective treatment of calcium and phosphorus metabolic disorders,reflects the unique advantages of traditional Chinese medicine,has a good promotional value.Network pharmacology: Shenshuaifang treatment of CKD with calcium and phosphorus metabolism disorder is a variety of active ingredients work together to protect renal function and improve calcium and phosphorus metabolism through anti-oxidative stress,regulation of apoptosis,inflammatory response,negative regulation of phosphate metabolism and other biological processes,intervention of disease pathway,AGE-RAGE pathway,chemical carcinogen-receptor activation and other pathways.