肾元颗粒对慢性肾脏病3~5期非透析患者血清成纤维细胞生长因子23、成纤维细胞生长因子受体4、Klotho蛋白的影响

Effect of Shenyuan Granules on serum fibroblast growth factor 23,fibroblast growth factor receptor 4 and Klotho protein in non-dialysis patients with chronic kidney disease of stage 3-5

目的观察肾元颗粒对慢性肾脏病(CKD)3~5期非透析患者的血清成纤维细胞生长因子23(FGF23)、成纤维细胞生长因子受体4(FGFR4)和Klotho蛋白含量的影响,以探讨肾元颗粒对CKD患者血管钙化的可能作用机制。方法选取湖北省中医院2018年6月—2019年6月收治的CKD患者60例,按随机数字表法将其分为对照组(28例)和治疗组(32例)。对照组采用尿毒清颗粒治疗,治疗组采用肾元颗粒治疗。连续治疗3个月,观察两组治疗前后生化指标[血清钙、磷、甲状旁腺激素(PTH)及估算的肾小球滤过率(eGFR)]水平及血清FGF23、FGFR4和Klotho蛋白含量。结果治疗前,两组钙、磷、PTH、eGFR比较,差异无统计学意义(P>0.05);治疗后,治疗组血清中磷、PTH含量低于对照组,钙、eGFR高于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组FGF23、FGFR4、Klotho蛋白含量比较,差异无统计学意义(P>0.05);治疗后治疗组血清FGF23、Klotho蛋白含量高于对照组,FGFR4含量低与对照组,差异均有统计学意义(均P<0.05)。结论肾元颗粒能够抑制FGF23、FGFR4水平,提高Klotho蛋白含量,这可能是肾元颗粒治疗CKD患者血管钙化作用机制之一。

Objective To observe the effect of Shenyuan Granules on the serum fibroblast growth factor 23(FGF 23),fibroblast growth factor receptor 4(FGFR 4)and Klotho protein in non-dialysis patients with chronic kidney disease(CKD)of stage 3-5,so as to explore the possible mechanism of Shenyuan Granules on vascular calcification in CKD patients.Methods A total of 60 patients with CKD admitted to Hubei Provincial Hospital of Traditional Chinese Medicine from June 2018 to June 2019 were selected and they were divided into the control group(28 cases)and the treatment group(32 cases)by random number table method.The control group was treated with Niaoduqing Granules,while the treatment group was treated with Shenyuan Granules.After 3 months of continuous treatment,the levels of biochemical indexes(serum calcium,phosphorus,parathyroid hormone[PTH]and estimated glomerular filtration rate[GFR]),and serum FGF23,FGFR4 and Klotho protein content were observed before and after treatment.Results Before treatment,there were no statistically significant differences in calcium,phosphorus,PTH and eGFR between the two groups(P>0.05).After treatment,serum phosphorus and PTH in the treatment group were lower than those inthe control group,while calcium and eGFR were higher than that in the control group,with statistically significant differences(all P<0.05).Before treatment,there was no significant difference in FGF23,FGFR4,and Klotho protein content between the two groups(P>0.05).After treatment,serum FGF23 and Klotho protein content in the treatment group were higher than those in the control group,and FGFR4 content was lower than that in the control group,with statistically significant differences(all P<0.05).Conclusion Shenyuan Granules can inhibit FGF23 and FGFR4 levels and increase Klotho protein content,which may be one of the mechanisms of Shenyuan Granules in the treatment of vascular calcification in patients with CKD.