Effect of Huangqi Yishen Granules combined with sevelamer on TLR4 and NF-κB in patients with maintenance hemodialysis
Objective To investigate the effect of Huangqi Yishen granule combined with sevelamer on the efficacy and Toll-like receptor 4 (TLR4) and nuclear transcription factor-κB (NF-κB) in patients with maintenance hemodialysis (MHD).Methods The clinical data of 118 MHD patients admitted to Lu'an City Lu'an World Hospital from January 2019 to November 2022 were retrospectively analyzed.They were divided into a control group(n=52) and a combined group(n=66) according to different treatment methods.The control group received routine treatment+sevelamer (0.8 g/time,3 times/d).The combined group received routine treatment+sevelamer+Huangqi Yishen Granules (15 g/time,2 times/d),both groups were treated for 2 months.The clinical efficacy,renal function[24 h urinary protein excretion rate (UPE),serum creatinine (SCr),blood urea nitrogen (BUN)],microinflammatory state[interleukin (IL-6),neutrophil/lymphocyte ratio (NLR),tumor necrosis factor-a (TNF-a)],TLR4,NF-κB mRNA levels and incidence of adverse reactions were statistically analyzed before and 2 months after treatment in the two groups.Results After 2 months of treatment,the total effective rate of the combined group was significantly higher than that of the control group,and the difference was statistically significant (x2=5.449,P<0.05).After treatment,UPE,SCr and BUN in the two groups decreased,and those in the combined group were lower,the differences were statistically significant (t=5.953,2.900,8.309,P<0.05).After treatment,IL-6,NLR,and TNF-α in both groups decreased,and those in the combined group were lower,the differences were statistically significant (t=4.956,3.841,5.098,P<0.05).There was no significant difference in TLR4 and NF-κB mRNA levels between the two groups before treatment (t=1.526,0.622,P>0.05).After treatment,TLR4 and NF-κB mRNA in both groups decreased,and those in the combined group were lower,the differences were statistically significant (t=4.714,4.494,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (x2=0.015,P=0.903).Conclusion Huangqi Yishen Granule combined with sevelamer can improve the therapeutic effect on MHD patients.This combination has been shown to enhance renal function and reducemicro-inflammatory states.These improvements may be linked to the suppression of TLR4 and NF-κB expression.
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