蓉黄颗粒对非透析CKD-MBD肾虚湿热证患者血清FGF23的影响

目的:观察非透析慢性肾脏病矿物质和骨代谢异常(CKD-MBD)且辨证为肾虚湿热证的患者血清成纤维细胞生长因子23(FGF23)水平的变化及蓉黄颗粒的干预作用。方法:将66例符合纳入标准的非透析CKD-MBD肾虚湿热证患者随机分为观察组与对照组各33例,最终实际完成62例,其中观察组32例,对照组30例,并设正常组20例。两组患者均给予西医常规治疗及中药保留灌肠,观察组加用蓉黄颗粒冲服,每日3次,每次1袋。疗程均8周。观察两组患者肾虚湿热证证候变化,检测两组患者治疗前后血清钙(Ca)、磷(P)、甲状旁腺激素(iPTH)和FGF23水平。结果:观察组疾病临床疗效显著优于对照组(P <0. 01)。两组患者证候积分值均随疗程增加而明显降低(P <0. 05或P <0. 01);观察组各个时间点疗效均显著优于对照组(P <0. 01)。治疗后,观察组血清Ca、P、iPTH均较治疗前显著改善(P <0. 05或P <0. 01);对照组除iPTH水平显著改善(P <0. 05)外,其余各项指标均无明显改善(P> 0. 05);治疗后观察组血清Ca、P、iPTH水平均显著优于对照组(P <0. 05)。治疗前,两组患者血清FGF23水平均显著高于正常组(P <0. 01);治疗后,观察组血清FGF23水平显著降低(P <0. 05);对照组血清FGF23水平无明显改善(P> 0. 05);观察组血清FGF23水平显著低于对照组(P <0. 05)。结论:蓉黄颗粒可改善非透析CKD-MBD肾虚湿热证患者的临床症状并纠正骨代谢紊乱。

Effect of Rong Huang granules of patients with non-dialysis kidney deficiency damp heat syndrome and chronic kidney disease mineral and bone metabolism disorder to serum FGF23 levels

Objective: To observe the changes of serum fibroblast growth factor 23(FGF23) levels in non-dialysis patients with chronic kidney disease mineral and bone metabolism disorder(CKD-MBD) and syndrome of kidney deficiency and damp heat and observe the therapeutic effect of these patients using Rong Huang Granule.Methods: 66 cases of non-dialysis CKD-MBD patients with syndrome of kidney deficiency and damp heat which met the inclusion criteria were randomly divided into observation group and control group.In the end,62 cases were actually completed,including 32 cases in the observation group and 30 cases in the control group.A normal group of 20 cases was set up.Two groups of patients were given the conventional therapy of western medicine and retention enema of traditional Chinese medicine.Rong Huang Granule was added to the observation group during the treatment.It was used three times a day,one bag each time.The course of treatment lasted 8 weeks.The changes of syndrome of kidney deficiency and damp heat in two groups of patients were observed.Serum calcium(Ca),phosphorus(P),intact parathyroid hormone(i PTH) and FGF23 in two groups of patients were tested before and after treatment.Results: The clinical efficacy of the observation group was significantly better than that of the control group(P < 0.01).The scores of syndromes in the two groups were significantly decreased along with the increase of the course of treatment(P < 0.05 or P < 0.01).The efficacy of the observation group was significantly better than that of the control group at each time point(P < 0.01).The serum levels of Ca,P and i PTH in the observation group were significantly improved after treatment(P < 0.05 or P < 0.01).In addition to the improvement in the level of i PTH in the control group(P < 0.05),no other indicators had improved significantly.The serum levels of Ca,P and i PTH in the observation group were significantly better than those in the control group after treatment(P < 0.05).The serum levels of FGF23 in the two groups were significantly higher than those in the normal group before treatment(P < 0.01).The serum level of FGF23 in the observation group was significantly decreased after treatment(P <0.05),while the serum level of FGF23 in control group was not significantly improved(P > 0.05).The serum level of FGF23 in the observation group was significantly lower than that in the control group after treatment(P < 0.05).Conclusion: Rong Huang Granule can improve the clinical symptoms of non-dialysis CKD-MBD patients with syndrome of kidney deficiency and damp heat and improve the disorder of bone metabolism.