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AIM: To explore the clinical efficacy of three different kinds of Chinese patent medicines combined with tacrolimus and hormone in the treatment of nephrotic syndrome (NS). METHODS: A total of 199 patients with NS treated in department of nephrology of our hospital from January 2018 to December 2020 were analyzed retrospectively. All patients were treated with tacrolimus combined with hormone regimen for 12 weeks. According to different treatment schemes, they were divided into 4 groups: 57 cases in the control group, 51 cases in the Bailing capsule group (Bailing group), 55 cases in the Huangkui capsule group (Huangkui group) and 36 cases in the Wuzhi capsule group (Wuzhi group). The general data of patients, the biochemical indexes before and after treatment, and the tacrolimus blood concentration were collected. RESULTS: After 12 weeks of treatment, 24 h UTP and ALB of each group were statistically different (P<0.01). Compared with the control group, Bailing group had statistically significant differences in the reduction of TG and TC (P<0.05), Huangkui group had statistically significant differences in the reduction of 24 h UTP and serum TC (P<0.05), Wuzhi group had statistically significant differences in the reduction of 24 h UTP and AST (P<0.05). The steady-state trough concentration (C
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Uremic toxins are harmful substances that accumulate in the body when the renal function declines in patients with chronic kidney disease (CKD). It is an important factor contributing to accelerated progression of CKD. There is no effective treatment for reducing uremic toxins. As an extensively used medicine for treatment of CKD in the clinic, Huangkui capsule is effective but the mechanism of its action remains unclear. This study investigated the effect of Huangkui on the accumulation of uremic toxins in CKD rats, with the discussion about its mechanism of action. UPLC-TQ/MS was used to detect the accumulation of uremic toxins in CKD rats after oral gavage with Huangkui. 16S rDNA sequencing technology was used to analyze the gut bacteria composition in rats. HPLC-FLD was used to detect the uremic toxins and their molecular precursors in feces. The effect and mechanism of Huangkui on the uremic toxin precursor in gut bacteria were studied by anaerobic culture system in vitro. All procedures were approved by the Institutional Animal Care and Use Committee of the Nanjing University of Chinese Medicine. The results showed that Huangkui (0.675 g·kg-1) could effectively inhibit the accumulation of uremic toxin indoxyl sulfate (IS) in CKD rats, with IS concentration in rat's plasma, liver and kidney decreased by 49.5%, 68.9% and 40.6%, respectively. Huangkui didn't affect the metabolic pathway of IS in host liver, didn't intervene the process of the IS precursor molecule indole conversion to IS. Instead, Huangkui significantly decreased the indole content in gut, with the indole in CKD rat's feces decreased by 46.4%, suggesting that the gut bacteria may be a target for intervene IS biosynthesis by Huangkui. Huangkui didn't affect the abundance of enterobacteriaceae bacteria (the main gut flora of indole synthesis) in CKD rats, suggesting that Huangkui didn't interfere with indole biosynthesis by directly affecting the abundance of indole synthesis related bacteria. Huangkui at 4 000, 400, 40, and 4 μg·mL-1 showed a dose-dependent inhibition of the indole production by gut bacteria in vitro. The bacteria tryptophan transport concentration decreased from 83.4 μmol·L-1 to 43.6 μmol·L-1 after co-incubated with Huangkui for 12 h, suggesting that Huangkui inhibited indole production of gut bacteria by interfering with tryptophan transportation. These results indicate that gut bacteria may be a potential target for alleviation of uremic toxin accumulation and for delaying CKD progression.
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Objective To study the clinical effect of Huangkui capsule combined with valsartan in the treatment of diabetic nephropathy.Methods50 patients with diabetic nephropathy treated in our hospital from April 2014 to October 2016 were selected as the research object in this study.They were randomly divided into the control group and the experimental group (n=two), with each group having a total of 25 patients.The control group was treated with valsartan treatment, patients in the experimental group of Huangkui capsule combined with valsartan treatment, comparative analysis of the experimental group and the control group of patients the treatment effect and total cholesterol and urinary albumin excretion rate.ResultsBefore treatment, there was no significant difference between the experimental group and the control group in terms of triglyceride, total cholesterol and urinary albumin excretion rate, and there was no statistical significance.After treatment, the urinary protein excretion rate and cholesterol and triglyceride levels in the experimental group were significantly lower than those in the control group, with statistical difference (P<0.05).In the control group of 25 patients, the total effective number of cases in the case of 20 cases, the effective rate was 80.0%.In the control group of 25 patients, the total effective number of cases in the case of 24 cases, the effective rate was 96.0%.As a result, the treatment effect of the patients in the control group was significantly lower than that in the experimental group, with statistical difference (P<0.05).There were no serious complications in diabetic nephropathy patients in the experimental group and the control group.ConclusionHuangkui capsule combined with valsartan in the treatment of diabetic nephropathy can improve the treatment efficiency to a great extent, high safety, no significant adverse reactions, improve the quality of life of patients, the maximum extent to reduce the pain of patients, with further clinical promotion and application significance.
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Objective To observe the clinical effect ofHuangkui capsule combined with benzbromarone on the treatment of the patients with chronic uric acid nephropathy (CUAN).Methods A total of 60 patients were recruited and divided into the treatment group and the control group by using the random number table method, each group 30 patients. Two groups were treated with conventional treatment, such as low purine, low protein diet, quit smoking and drinking extra water. The control group was added with oral benzbromarone, and the treatment group was added with oralHuangkui capsule. All the treatments last 8 weeks. Theblood uric acid (BUA), serum creatinine (SCr), blood urea nitrogen (BUN), cystatin C (Cys-C), SOD, 24-hour urinary protein quantity and Urinary sediment red blood cell count were detected by the automatic biochemical analyser.The clinical effect was evaluated by the Rheumatoid arthritis (RA) quality of life questionnaire.Results Compared with the control group, the total effective rate in the treatment group was 86.64% (26/30), which was significantly higher than that of 63.33% (19/30) in the control group (χ2=7.264, P=0.001). After treatment, the BUA (273.52 ± 110.37μmol/Lvs. 331.28 ± 126.54μmol/L,Z=-2.543), BUN (6.24 ± 1.23 mol/Lvs. 8.16 ± 2.35 mol/L,Z=-2.680), SCr (90.37 ± 20.16μmol/Lvs. 110.38 ± 16.72μmol/L,Z=-2.534), Cys C (0.86 ± 0.51 vs. 1.03 ± 0.10,Z=-2.372) in the treatment group were lower than those of the control group (P<0.01); SOD (156.37 ± 32.04μmol/Lvs. 43.36 ± 31.52μmol/L,Z=-2.041) in the treatment group was higher than that in the control group (P<0.01); the 24 hours urinary protein (439.86 ± 250.41 mg/24hvs.897.69 ± 213.37 mg/24h,Z=-2.853), urine sediment RBC counts (50.31 ± 14.06 points/μlvs.213.47 ± 38.46 points/μl, Z=-2.106) in the treatment group were lower than those in the control group (P<0.01); the physiological function(43.14 ± 2.06 pointsvs.36.48 ± 3.21 points,Z=10.362), the psychological function (40.76 ± 3.28 points vs. 16.54 ± 3.71 points,Z=9.547), social function (40.74 ± 3.58 points vs. 33.04 ± 5.48 points,Z=6.034), healthy self-awareness (24.57 ± 1.97 points vs. 22.63 ± 3.43 points,Z=4.236) and total score (127.38 ± 6.43 points vs. 107.69 ± 13.57 points,Z=6.754) in the treatment group were higher than those in the control group (P<0.01) . Conclusions TheHuangkui capsule combined with benzbromarone could reduce CUAN patient's blood uric acid levels, protect renal function, and improve the quality of life.
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Objective To discuss clinical curative effect and value of valsartan combined with Huangkui capsule on the chronic glomerulonephritis proteinuria.Methods 70 cases of patients with chronic glomerulonephritis proteinuria were selected in our hospital,and randomly divided into two groups,35 cases in control group with valsartan oral,80 mg per time,once per day,8 weeks as a course of treatment;35 cases in experimental group, combined with Huangkui capsule on the basis of conventional treatment orally,5 capsules per time,3 times per day,8 weeks for a period of treatment. After 8 weeks treatment,changes of serum creatinine,serum urea nitrogen,the urine protein and clinical therapeutic effect were compared before and after treatment in two groups.Results Contents of serum urea nitrogen,serum creatinine,urine protein were improved in two groups after treatment, and serum creatinine contents of experimental group (153.69 ±13.78)μmol/L was lower than that of control group (179.19 ±23.49)μmol/L,and the difference was statistically significant (P<0.05);serum urea nitrogen contents of experimental group (7.09 ±1.16)mmol/L was lower than that of control group (9.29 ±2.38)mmol/L,and the difference was statistically significant (P<0.05);urine protein contents of experimental group (0.57 ± 0.32)g/L was lower than that of control group (0.89 ±0.26)g/L,and the difference was statistically significant(P<0.05);clinical curative effect of experimental group was better than that of control group,and the difference was statistically significant(P<0.05 ).Conclusion Valsartan combined with Huangkui capsule could effectively reduce albuminuria symptomsin the treatment of patients with chronic glomerulonephritis proteinuria,which has a remarkable effect,and has a positive significance for the renal function recovery.
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OBJECTIVE: To establish the HPLC fingerprint of traditional Chinese medicine Huangkui Capsules, thus to provide an approach and a basis for the quality control in production. METHODS: The analytical column was Thermo scientific Hypersil GOLD. The mobile phase was composed of acetonitrile (A) and 0.2% phosphoric acid (B) with gradient elution. The flow rate was 0.8 mL · min-1, and the detection wavelength was set at 360 nm with the column temperature maintained at 30°C. The fingerprints of the extracts from the raw materials, intermediate product, and Huangkui Capsules were compared. RESULTS: The similarities of the chromatograms of 10 different lots of Huangkui Capsules were over 0.95. The correlation was good between the raw materials, intermediate product and Huangkui capsules. CONCLUSION: This validated method is suitable for the quality evaluation and quality control of Huangkui Capsules.
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Objective To observe the effect and safety of tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy.Methods 128 diabetic nephropathy patients were classified into two groups,observation group of 64 cases were treated with tripterygium combined with huangkui capsule and control group of 64 cases were treated with huangkui capsule.The clinical effect,urinary protein between the two groups were compared.Results The total effective rate in observation group ( 82.8％ ) was significantly higher than that in control group (65.6％) ( x2 =4.940,P ＜ 0.05 ).After treatment,the levels of 24h urinary microalbumin and α1-microglobulin were significantly decreased in both groups( t =4.131,3.912,7.253,6.517,all P ＜ 0.05 ).Moreover,the levels of 24h urinary microalbumin and α1-microglobulin in observation group were significantly lower than those in control group( t =5.114,4.526,all P ＜ 0.05 ).Conclusion Tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy could enhance the clinical effects,degrade urinary protein lelves,and had less adverse effect.
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AIM:To observe the clinical effects of Huangkui Capsule (Abelmoschus manihot (Linn)Medic.)on the treatment of IgA nephropathy of damp-heat syndrome.METHODS: Sixty-four patients were assigned randomly into two groups: treatment group in which 32 cases were treated with Huangkui Capsule,and control group,in which 32 cases were treated with fosinopril.The therapeutic course for both groups was 12 weeks.The indexes of efficacy ,including damp-heat syndrome scores,24 h urinary protein,serum creatinine,urea nitrogen and the indexes of safety,including liver function,electrolyte and occurrence of adverse events were observed.RESULTS :There was no significant statistical difference between the two groups in aspects of baseline clinical figures,after 12 weeks of treatment,the content of 24h urinary protein significantly decreased by (0.49±0.78 )g/24 h and (0.4±0.76 ) g/24 h respectively in the two groups,showing significant difference in comparing with baseline,but insignificant difference between the two groups ( P ＞ 0.05 ),the scores of damp-heat syndrome in the two groups decreased by (0.88±1.43 ) scores and (1.94±1.63 ) scores respectively with significant difference as compared with baseline (P ＜0.05 ),and in comparison between groups(P ＜0.05 ).The total effective rate of 24 h urinary protein was 53.1% in the treatment group and 65.6% in the control group (P ＞ 0.05 ),The total effective rate of dampheat syndrome scores was 84.4% in the treatment group and 50% in the control group ( P ＞ 0.05 ).No significant change in levels of serum creatinine,urea nitrogen in the two groups was found (P ＞0.05 ).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION: Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.
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0.05).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION:Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.