Effect of Modified Shenling Baizhusan on Gastrointestinal Dysfunction and Protein-energy Wasting in Continuous Ambulatory Peritoneal Dialysis Patients / 中国实验方剂学杂志

ObjectiveTo observe and analyze the effect of modified Shenling Baizhusan on gastrointestinal dysfunction and protein-energy wasting （PEW） of continuous ambulatory peritoneal dialysis （CAPD） patients with the syndrome of spleen deficiency， blood stasis， and dampness. MethodA total of 66 CAPD patients with the above syndrome were randomized into the observation group and control group， 33 cases in each group. However， 3 cases in each group dropped out， finally leaving 30 cases in each group. Both groups received CAPD and conventional symptomatic treatment. On this basis， the observation group was given modified Shenling Baizhusan （1 bag/day， once in the morning and again in the evening， 12 weeks）， and the control group the bifidobacterium capsules （1.05 g/time， twice/day， 12 weeks）. Before and after treatment， the traditional Chinese medicine （TCM） syndrome score， gastrointestinal symptom rating scale （GSRS） score， and malnutrition-inflammation score （MIS） in two groups were recorded， and the levels of serum albumin （ALB）， prealbumin （PA）， transferrin （TRF）， gastrin-17 （G-17）， tumor necrosis factor alpha （TNF-α）， interferon-γ （IFN-γ）， and interleukin-10 （IL-10） were detected. Moreover， body mass index （BMI） was calculated. ResultAfter treatment， the alleviation of the TCM syndrome in the observation group was better than that in the control group （Z=-2.591， P<0.05）， and the TCM syndrome score in the observation group was lower than that in the control （P<0.05）. The symptom scores， MIS， and G-17 of the observation group were significantly decreased compared with those before observation and in the control group （P<0.05）. After treatment， the GSRS scores of the two groups were significantly lower than those before treatment （P<0.05）， particularly the observation group （P<0.05）. ALB， PA， TRF， and BMI of the observation group after treatment were increased compared with those before treatment and those of the control group after treatment （P<0.05）. After treatment， serum TNF-α and IFN-γ of the two groups were significantly reduced compared with those before treatment （P<0.05）， and the levels of the two in the observation group were significantly lower in the observation group than in the control group （P<0.05）. After treatment， IL-10 level of the observation group was higher than that before treatment and in the control group （P<0.05）. ConclusionThe modified Shenling Baizhusan can relieve the gastrointestinal dysfunction and PEW in CAPD patients with the syndrome of spleen deficiency， blood stasis， and dampness.

Therapeutic Role of Tangshenkang Granule () in Rat Model with Diabetic Nephropathy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the renal protective effect of Tangshenkang Granule () in a rat model of diabetic nephropathy (DN).</p><p><b>METHODS</b>Forty male Sprague-Dawley rats were randomly divided into control, DN, Tangshenkang and benazepril groups. DN model was established in the rats of DN, Tangshenkang and benazepril groups. Tangshenkang Granule solution and benazepril hydrochloride solution were intragastrically administered daily to the rats in the Tangshenkang and benazepril groups for 8 weeks, respectively. Urinary albumin and creatinine were detected. The albumin/creatinine (ACR) was calculated in addition to 24 h urinary protein (24-h UPr), serum creatinine (Scr), blood urea nitrogen (BUN), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and creatinine clearance rate (Ccr). Right kidneys were harvested for pathological observation using periodic acid-silver methenamine-Masson staining. The average glomerular diameter (DG), average glomerular (AG) and mesangial areas (AM) were measured. The thickness of glomerular basement membrane (TGBM) was detected using transmission electron microscope.</p><p><b>RESULTS</b>Compared with rats in the control group, rats in the DN group showed significantly decreased body weight, increased hypertrophy index, 24-h urinary volume, 24-h UPr, ACR, Scr, BUN, Ccr, blood lipids as well as renal pathological indices including DG, AG, AM, AM/AG and TGBM (P <0.05). Compared with the DN group, the weights of rats in the Tangshenkang and benazepril groups were significantly increased, and the renal hypertrophy indices were significantly decreased (P <0.05). The 24-h urinary volumes, ACR, 24-h UPr, Scr, BUN, Ccr, LDL, DG, AG, AM and TGBM were obviously decreased (P <0.05). Compared with the benazepril group, the Tangshenkang group showed significantly decreased levels of ACR, 24-h UPr, AG and AM (P <0.05).</p><p><b>CONCLUSIONS</b>Tangshenkang Granule decreased the urinary protein, attenuated the high glomerular filtration rate and improved lipid metabolism in DN rats, and prevented further injury induced by diabetic nephropathy.</p>

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 OPG and RANKL levels / 中国免疫学杂志

Objective:To observe serum osteoprotegerin (OPG),receptor activator of NF-kB ligand (RANKL) levels and the therapeutic effect of Rong Huang granules of patients with non-dialysis chronic kidney disease mineral and bone metabolism disorder (CKD-MBD) and kidney deficiency damp heat syndrome.Methods:70 cases of non-dialysis CKD-MBD with kidney deficiency damp heat syndrome,were randomly divided into treatment group and control group,the actual completion of 61 cases,30 cases in treatment group,31 cases in the control group;and a healthy normal group of 20 cases of patients was established.Two groups of patients were given symptomatic treatment,in addition,Rong Huang granules was plused in treating at treatment group and it was used three times a day,each time blunt one bag.The course of treatment was 8 weeks.The changes of kidney deficiency damp heat syndrome,blood urea nitrogen (BUN),serum creatinine (Scr),estimated glomerular filtration rate (eGFR),serum of calcium (Ca),phosphorus (P), alkaline phosphatase (ALP),parathyroid hormone (iPTH),OPG and RANKL levels were observed in two groups of patients.Results:The total effective rate in treatment group was significantly better than the control group(P<0.01).The integral value of syndrome decreased more significantly with the course of treatment increased of two groups of patients(P<0.01).Compared with the same period of therapy,the descender in the treatment group was significantly better than that in the control group(P<0.01).The levels of BUN, Scr,eGFR,Ca,P,iPTH and ALP were improved in the treatment group after treatment(P<0.05 or P<0.01),BUN and iPTH were improved in the control group(P<0.05 or P<0.01),other indexes were not improved(P>0.05).After treatment,BUN,Scr,eGFR,Ca, P,iPTH,ALP of treatment group were significantly better than the control group(P<0.05 or P<0.01).Compared with the normal group,the levels of OPG and RANKL were significantly higher in CKD-MBD patients (P<0.01).After treatment,serum OPG level, serum RANKL level and OPG/RANKL ratio were significantly improved than before treatment in treatment group(P<0.05 or P<0.01),and in the control group,only the OPG/RANKL ratio increased(P<0.01).After treatment,OPG,RANKL and OPG/RANKL ratio in the treatment group were obviously improved compared with them in the control group(P<0.05 or P<0.01).Conclusion:The levels of OPG and RANKL in non-dialysis CKD-MBD patients with kidney deficiency damp heat syndrome were higher than those in healthy people,and the ratio of OPG/RANKL was lower than that in healthy people.Rong Huang granules can ameliorate clinical symptoms,prevent calcium and phosphorus metabolism,improve renal function,the mechanism may be related to the ameliorate of serum OPG and the decrease of serum RANKL level and the raise of ratio of OPG/RANKL.