Hu Shunjin, Wang Dong, Zhang Rui, Cao Yuanru, Jin Hua, Mao Yanping, Wei Ling, Ren Kejun, Zhang Xuelian, Wang Yiping
First Affiliated Hospital, Anhui University of Chinese Medicine, Heifei 230000, China.
Graduate School, Anhui University of Chinese Medicine, Heifei 230000, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2018 Dec 30;38(12):1427-1432. doi: 10.12122/j.issn.1673-4254.2018.12.05.
To observe the effect of Ronghuang granule on serum fibroblast growth factor 23 (FGF23), fibroblast growth factor receptor (FGFRs) and Klotho protein levels in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and kidney deficiency and damp heat syndrome.
Seventy non-dialysis CKD-MBD patients with kidney deficiency and dampness-heat syndrome were randomized into control group (=35) and treatment group (=35). All the patients were given routine treatment combined with traditional Chinese medicine retention enema, and the patients in the treatment group received additional Ronghuang granule treatment (3 times a day). After the 12-week treatments, the patients were examined for changes of TCM syndromes. Serum levels of Ca, P, parathyroid hormone (iPTH), FGF23, FGFRs and Klotho proteins were detected before and after treatment. These parameters were also examined in 20 healthy volunteers.
Sixty-five patients completed the study, including 33 in the control group and 32 in the treatment group. The patients in the treatment group showed significantly better treatment responses than those in the control group ( < 0.05 or 0.01). At 4, 8, and 12 weeks of treatment, the patients in the treatment group had significantly lowered scores of TCM syndromes compared with the score before treatment ( < 0.05 or 0.01), while in the control group, significant reduction of the scores occurred only at 12 weeks ( < 0.05); at each of the time points, the treatment group had significantly greater reductions in the score than the control group ( < 0.01). Significant improvements in serum Ca, P and iPTH levels were observed at 4, 8, and 12 weeks in the treatment group ( < 0.05) but only at 12 weeks in the control group ( < 0.05). The patients in the control and treatment groups all showed elevated serum levels of FGF23, FGFRs and Klotho protein compared with the normal subjects ( < 0.01); FGF23, FGFRs and Klotho levels were significantly reduced in the treatment group ( < 0.05) but remained unchanged in the control group (>0.05), showing significant differences between the two groups.
Ronghuang granule improves the clinical symptoms of non-dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome by reducing serum levels of FGF23, FGFRs and Klotho, improving calcium and phosphorus metabolism disorder, and inhibiting secondary hyperparathyroidism.
观察蓉黄颗粒对慢性肾脏病 - 矿物质和骨异常（CKD - MBD）且兼肾虚湿热证非透析患者血清成纤维细胞生长因子23（FGF23）、成纤维细胞生长因子受体（FGFRs）及Klotho蛋白水平的影响。
将70例兼肾虚湿热证的非透析CKD - MBD患者随机分为对照组（n = 35）和治疗组（n = 35）。所有患者均给予常规治疗并结合中药保留灌肠，治疗组患者加用蓉黄颗粒治疗（每日3次）。治疗12周后，观察患者中医证候变化。检测治疗前后患者血清钙（Ca）、磷（P）、甲状旁腺激素（iPTH）、FGF23、FGFRs及Klotho蛋白水平。同时检测20名健康志愿者上述指标。
65例患者完成研究，其中对照组33例，治疗组32例。治疗组患者治疗反应明显优于对照组（P < 0.05或0.01）。治疗4、8、12周时，治疗组患者中医证候积分较治疗前明显降低（P < 0.05或0.01），而对照组仅在12周时积分明显降低（P < 0.05）；各时间点治疗组积分降低幅度均明显大于对照组（P < 0.01）。治疗组在4、8、12周时血清Ca、P及iPTH水平均有明显改善（P < 0.05），而对照组仅在12周时有明显改善（P < 0.05）。与正常受试者相比，对照组和治疗组患者血清FGF23、FGFRs及Klotho蛋白水平均升高（P < 0.01）；治疗组FGF23、FGFRs及Klotho水平明显降低（P < 0.05），而对照组无明显变化（P > 0.05），两组间差异有统计学意义。
蓉黄颗粒可通过降低血清FGF23、FGFRs及Klotho水平，改善钙磷代谢紊乱，抑制继发性甲状旁腺功能亢进，从而改善兼肾虚湿热证的非透析CKD - MBD患者的临床症状。
