Journal of Traditional Chinese Medicine ›› 2026, Vol. 46 ›› Issue (4): 990-999.DOI: 10.19852/j.cnki.jtcm.20260423.001
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Efficacy of Yishen Jiangzhuo granules (益肾降浊颗粒) in the treatment of chronic kidney disease stages 3-4: a retrospective cohort study
RUAN Yaqing, RUAN Shiwei, YE Binhua, YU Yongxin(
), ZHENG Kailin()
People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine Fuzhou 350004, China
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Received:2025-09-24Accepted:2026-01-26Online:2026-08-15Published:2026-04-23 -
Contact:Prof. ZHENG Kailin, Prof. YU Yongxin, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou 350004, China. 526411471@qq.com; yongxin0705@163.com,Telephone: +86-15880434277
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Supported by:Fujian Provincial Natural Science Foundation Project(2024J01756);Fujian University of Chinese Medicine Institutionally Managed Clinical Special Project(XB2024020);Self-selected Project of Fujian University of Chinese Medicine Affiliated People's Hospital(2025-26)
Cite this article
RUAN Yaqing, RUAN Shiwei, YE Binhua, YU Yongxin, ZHENG Kailin. Efficacy of Yishen Jiangzhuo granules (益肾降浊颗粒) in the treatment of chronic kidney disease stages 3-4: a retrospective cohort study[J]. Journal of Traditional Chinese Medicine, 2026, 46(4): 990-999.
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Figure 1 Research Flowchart eGFR: estimated glomerular filtration rate; PSM: propensity score matching.
Figure 1 Research Flowchart eGFR: estimated glomerular filtration rate; PSM: propensity score matching.
Table 1 Baseline characteristics of the two groups before and after PSM
| Variable | Raw data (n = 1168) | P value | PSM-adjusted (n = 335) | P value | |||
|---|---|---|---|---|---|---|---|
| Non-exposed group (n = 1079) | Exposed group (n = 89) | Non-exposed group (n = 248) | Exposed group (n = 87) | ||||
| Sex [n (%)] | 0.867 | 0.873 | |||||
| Female | 361 (33.46) | 29 (32.58) | 85 (34.27) | 29 (33.33) | |||
| Male | 718 (66.54) | 60 (67.42) | 163 (65.73) | 58 (66.67) | |||
| Age group [n (%)] | <0.001 | 0.653 | |||||
| <60 years | 477 (44.21) | 59 (66.29) | 169 (68.15) | 57 (65.52) | |||
| ≥60 years | 602 (55.79) | 30 (33.71) | 79 (31.85) | 30 (34.48) | |||
| Age (years) | 63 (52, 69) | 53 (42, 64) | <0.001 | 56 (46, 64) | 54 (42, 65) | 0.395 | |
| GFR [mL·(min·1.73m2)-1] | 41.00 (27.90, 52.35) | 44.00 (28.93, 54.50) | 0.421 | 43.80 (26.09, 54.33) | 45.00 (28.93, 54.65) | 0.662 | |
| GFR staging [n (%)] | 0.644 | 0.345 | |||||
| CKD G3a | 466 (43.19) | 43 (48.31) | 120 (48.39) | 43 (49.43) | |||
| CKD G3b | 304 (28.17) | 23 (25.84) | 48 (19.35) | 22 (25.29) | |||
| CKD G4 | 309 (28.64) | 23 (25.84) | 80 (32.26) | 22 (25.29) | |||
| Scr (μmol/L) | 145.00 (120.70, 195.73) | 142.40 (119.00, 204.70) | 0.450 | 144.55 (120.07, 210.28) | 140.20 (118.40, 204.70) | 0.706 | |
| BUN (mmol/L) | 9.30 (7.86, 12.00) | 10.75 (8.41, 13.20) | 0.021 | 9.90 (8.41, 12.54) | 10.75 (8.4, 13.20) | 0.391 | |
| UA group [n (%)] | 0.598 | 0.635 | |||||
| Normal | 332 (30.77) | 25 (28.09) | 62 (25.00) | 24 (27.59) | |||
| ≥420/360 μmol/L | 747 (69.23) | 64 (71.91) | 186 (75.00) | 63 (72.41) | |||
| Alb group [n (%)] | <0.001 | 0.857 | |||||
| ≥35 g/L | 746 (69.14) | 80 (89.89) | 224 (90.32) | 78 (89.66) | |||
| <35 g/L | 333 (30.86) | 9 (10.11) | 24 (9.68) | 9 (10.34) | |||
| TG group [n (%)] | 0.104 | 0.038 | |||||
| <2.3 mmol/L | 842 (78.04) | 76 (85.39) | 184 (74.19) | 74 (85.06) | |||
| ≥2.3 mmol/L | 237 (21.96) | 13 (14.61) | 64 (25.81) | 13 (14.94) | |||
| K group [n (%)] | <0.001 | 0.140 | |||||
| ≥5.5 mmol/L | 35 (3.24) | 9 (10.11) | 12 (4.84) | 8 (9.20) | |||
| <5.5 mmol/L | 1044 (96.76) | 80 (89.89) | 236 (95.16) | 79 (90.80) | |||
| Na (mmol/L) | 139.90 (137.50, 142.00) | 140.00 (138.20, 142.20) | 0.211 | 140.00 (137.75, 142.20) | 140.00 (138.10, 142.20) | 0.282 | |
| Ca (mmol/L) | 2.20 (2.09, 2.31) | 2.23 (2.13, 2.30) | 0.431 | 2.21 (2.07, 2.29) | 2.23 (2.12, 2.30) | 0.269 | |
| P (mmol/L) | 1.17 (1.02, 1.34) | 1.15 (1.02, 1.28) | 0.333 | 0.84 (0.77, 0.92) | 0.83 (0.76, 0.88) | 0.364 | |
| uBLD [n (%)] | 0.002 | 0.972 | |||||
| ± | 0 (0.00) | 1 (1.12) | 80 (32.26) | 26 (29.89) | |||
| 1+ | 232 (21.50) | 26 (29.21) | 49 (19.76) | 19 (21.84) | |||
| 2+ | 186 (17.24) | 19 (21.35) | 23 (9.27) | 7 (8.05) | |||
| 3+ | 113 (10.47) | 7 (7.87) | 38 (15.32) | 15 (17.24) | |||
| +/- | 180 (16.68) | 15 (16.85) | 58 (23.39) | 20 (22.99) | |||
| - | 368 (34.11) | 21 (23.60) | - | - | |||
| uPRO [n (%)] | 0.893 | 0.952 | |||||
| 1+ | 161 (14.92) | 15 (16.85) | 50 (20.16) | 15 (17.24) | |||
| 2+ | 309 (28.64) | 29 (32.58) | 78 (31.45) | 28 (32.18) | |||
| 3+ | 190 (17.61) | 16 (17.98) | 39 (15.73) | 16 (18.39) | |||
| 4+ | 3 (0.28) | 0 (0.00) | 23 (9.27) | 7 (8.05) | |||
| +/- | 100 (9.27) | 7 (7.87) | 58 (23.39) | 21 (24.14) | |||
| - | 316 (29.29) | 22 (24.72) | - | - | |||
| T2DM [n (%)] | 0.146 | 0.803 | |||||
| Normal | 719 (66.64) | 66 (74.16) | 179 (72.18) | 64 (73.56) | |||
| T2DM | 360 (33.36) | 23 (25.84) | 69 (27.82) | 23 (26.44) | |||
| HTN [n (%)] | 0.093 | 0.063 | |||||
| Normal | 475 (44.02) | 31 (34.83) | 111 (44.76) | 29 (33.33) | |||
| HTN | 604 (55.98) | 58 (65.17) | 137 (55.24) | 58 (66.67) | |||
Table 1 Baseline characteristics of the two groups before and after PSM
| Variable | Raw data (n = 1168) | P value | PSM-adjusted (n = 335) | P value | |||
|---|---|---|---|---|---|---|---|
| Non-exposed group (n = 1079) | Exposed group (n = 89) | Non-exposed group (n = 248) | Exposed group (n = 87) | ||||
| Sex [n (%)] | 0.867 | 0.873 | |||||
| Female | 361 (33.46) | 29 (32.58) | 85 (34.27) | 29 (33.33) | |||
| Male | 718 (66.54) | 60 (67.42) | 163 (65.73) | 58 (66.67) | |||
| Age group [n (%)] | <0.001 | 0.653 | |||||
| <60 years | 477 (44.21) | 59 (66.29) | 169 (68.15) | 57 (65.52) | |||
| ≥60 years | 602 (55.79) | 30 (33.71) | 79 (31.85) | 30 (34.48) | |||
| Age (years) | 63 (52, 69) | 53 (42, 64) | <0.001 | 56 (46, 64) | 54 (42, 65) | 0.395 | |
| GFR [mL·(min·1.73m2)-1] | 41.00 (27.90, 52.35) | 44.00 (28.93, 54.50) | 0.421 | 43.80 (26.09, 54.33) | 45.00 (28.93, 54.65) | 0.662 | |
| GFR staging [n (%)] | 0.644 | 0.345 | |||||
| CKD G3a | 466 (43.19) | 43 (48.31) | 120 (48.39) | 43 (49.43) | |||
| CKD G3b | 304 (28.17) | 23 (25.84) | 48 (19.35) | 22 (25.29) | |||
| CKD G4 | 309 (28.64) | 23 (25.84) | 80 (32.26) | 22 (25.29) | |||
| Scr (μmol/L) | 145.00 (120.70, 195.73) | 142.40 (119.00, 204.70) | 0.450 | 144.55 (120.07, 210.28) | 140.20 (118.40, 204.70) | 0.706 | |
| BUN (mmol/L) | 9.30 (7.86, 12.00) | 10.75 (8.41, 13.20) | 0.021 | 9.90 (8.41, 12.54) | 10.75 (8.4, 13.20) | 0.391 | |
| UA group [n (%)] | 0.598 | 0.635 | |||||
| Normal | 332 (30.77) | 25 (28.09) | 62 (25.00) | 24 (27.59) | |||
| ≥420/360 μmol/L | 747 (69.23) | 64 (71.91) | 186 (75.00) | 63 (72.41) | |||
| Alb group [n (%)] | <0.001 | 0.857 | |||||
| ≥35 g/L | 746 (69.14) | 80 (89.89) | 224 (90.32) | 78 (89.66) | |||
| <35 g/L | 333 (30.86) | 9 (10.11) | 24 (9.68) | 9 (10.34) | |||
| TG group [n (%)] | 0.104 | 0.038 | |||||
| <2.3 mmol/L | 842 (78.04) | 76 (85.39) | 184 (74.19) | 74 (85.06) | |||
| ≥2.3 mmol/L | 237 (21.96) | 13 (14.61) | 64 (25.81) | 13 (14.94) | |||
| K group [n (%)] | <0.001 | 0.140 | |||||
| ≥5.5 mmol/L | 35 (3.24) | 9 (10.11) | 12 (4.84) | 8 (9.20) | |||
| <5.5 mmol/L | 1044 (96.76) | 80 (89.89) | 236 (95.16) | 79 (90.80) | |||
| Na (mmol/L) | 139.90 (137.50, 142.00) | 140.00 (138.20, 142.20) | 0.211 | 140.00 (137.75, 142.20) | 140.00 (138.10, 142.20) | 0.282 | |
| Ca (mmol/L) | 2.20 (2.09, 2.31) | 2.23 (2.13, 2.30) | 0.431 | 2.21 (2.07, 2.29) | 2.23 (2.12, 2.30) | 0.269 | |
| P (mmol/L) | 1.17 (1.02, 1.34) | 1.15 (1.02, 1.28) | 0.333 | 0.84 (0.77, 0.92) | 0.83 (0.76, 0.88) | 0.364 | |
| uBLD [n (%)] | 0.002 | 0.972 | |||||
| ± | 0 (0.00) | 1 (1.12) | 80 (32.26) | 26 (29.89) | |||
| 1+ | 232 (21.50) | 26 (29.21) | 49 (19.76) | 19 (21.84) | |||
| 2+ | 186 (17.24) | 19 (21.35) | 23 (9.27) | 7 (8.05) | |||
| 3+ | 113 (10.47) | 7 (7.87) | 38 (15.32) | 15 (17.24) | |||
| +/- | 180 (16.68) | 15 (16.85) | 58 (23.39) | 20 (22.99) | |||
| - | 368 (34.11) | 21 (23.60) | - | - | |||
| uPRO [n (%)] | 0.893 | 0.952 | |||||
| 1+ | 161 (14.92) | 15 (16.85) | 50 (20.16) | 15 (17.24) | |||
| 2+ | 309 (28.64) | 29 (32.58) | 78 (31.45) | 28 (32.18) | |||
| 3+ | 190 (17.61) | 16 (17.98) | 39 (15.73) | 16 (18.39) | |||
| 4+ | 3 (0.28) | 0 (0.00) | 23 (9.27) | 7 (8.05) | |||
| +/- | 100 (9.27) | 7 (7.87) | 58 (23.39) | 21 (24.14) | |||
| - | 316 (29.29) | 22 (24.72) | - | - | |||
| T2DM [n (%)] | 0.146 | 0.803 | |||||
| Normal | 719 (66.64) | 66 (74.16) | 179 (72.18) | 64 (73.56) | |||
| T2DM | 360 (33.36) | 23 (25.84) | 69 (27.82) | 23 (26.44) | |||
| HTN [n (%)] | 0.093 | 0.063 | |||||
| Normal | 475 (44.02) | 31 (34.83) | 111 (44.76) | 29 (33.33) | |||
| HTN | 604 (55.98) | 58 (65.17) | 137 (55.24) | 58 (66.67) | |||
Table 2 Comparison of endpoint event occurrence between the two groups
| Variable | All Patients (n = 335) | Non-exposed group (n = 248) | Exposed group (n = 87) | P value |
|---|---|---|---|---|
| Not reached the endpoint event [n (%)] | 123 (36.72) | 74 (29.84) | 49 (56.32) | <0.001 |
| Reached the endpoint event [n (%)] | 212 (63.28) | 174 (70.16) | 38 (43.68) | |
| Follow-up duration (years, IQR) | 2.18 (1.23, 3.90) | 1.98 (1.05, 3.57) | 2.98 (1.69, 6.35) | <0.001 |
Table 2 Comparison of endpoint event occurrence between the two groups
| Variable | All Patients (n = 335) | Non-exposed group (n = 248) | Exposed group (n = 87) | P value |
|---|---|---|---|---|
| Not reached the endpoint event [n (%)] | 123 (36.72) | 74 (29.84) | 49 (56.32) | <0.001 |
| Reached the endpoint event [n (%)] | 212 (63.28) | 174 (70.16) | 38 (43.68) | |
| Follow-up duration (years, IQR) | 2.18 (1.23, 3.90) | 1.98 (1.05, 3.57) | 2.98 (1.69, 6.35) | <0.001 |
Table 3 Fixed effects estimates of eGFR slope after PSM matching
| Variable | Estimate (β) [mL·(1.73 m2·min·year)-1] | Standard error | 95% CI |
|---|---|---|---|
| Overall eGFR slope (335) | －7.405 | 0.516 | (－8.419, －6.391) |
| eGFR slope of Group A (123/335) | －6.066 | 0.789 | (－7.621, －4.511) |
| eGFR slope of Group B (212/335) | －7.856 | 0.621 | (－.9.077, －6.634) |
| eGFR slope of non－exposed group (248/335) | －9.022 | 0.591 | (－10.182, －7.861) |
| eGFR slope of exposed group (87/335) | －3.880 | 0.895 | (－5.647, －2.113) |
Table 3 Fixed effects estimates of eGFR slope after PSM matching
| Variable | Estimate (β) [mL·(1.73 m2·min·year)-1] | Standard error | 95% CI |
|---|---|---|---|
| Overall eGFR slope (335) | －7.405 | 0.516 | (－8.419, －6.391) |
| eGFR slope of Group A (123/335) | －6.066 | 0.789 | (－7.621, －4.511) |
| eGFR slope of Group B (212/335) | －7.856 | 0.621 | (－.9.077, －6.634) |
| eGFR slope of non－exposed group (248/335) | －9.022 | 0.591 | (－10.182, －7.861) |
| eGFR slope of exposed group (87/335) | －3.880 | 0.895 | (－5.647, －2.113) |
Table 4 Coefficients of feature variables from lasso regression
| Variable | Coefficient |
|---|---|
| Sex | －0.541 |
| Age group | 0.030 |
| T2DM | 0.004 |
| HTN | 0.021 |
| YSJZ | －0.430 |
| eGFR | －0.034 |
| eGFR slope group | 1.059 |
| Scr | 0.006 |
| BUN | 0.077 |
| Alb group | 0.298 |
| TG group | 0.058 |
| UA group | －0.108 |
| K group | 0.000 |
Table 4 Coefficients of feature variables from lasso regression
| Variable | Coefficient |
|---|---|
| Sex | －0.541 |
| Age group | 0.030 |
| T2DM | 0.004 |
| HTN | 0.021 |
| YSJZ | －0.430 |
| eGFR | －0.034 |
| eGFR slope group | 1.059 |
| Scr | 0.006 |
| BUN | 0.077 |
| Alb group | 0.298 |
| TG group | 0.058 |
| UA group | －0.108 |
| K group | 0.000 |
Table 5 Results of cox multivariate regression analysis
| Characteristic | Number (%) | HR | 95% CI | P value | |
|---|---|---|---|---|---|
| Age group | <60 years | 226 (67.5) | Reference | Reference | Reference |
| ≥60 years | 109 (32.5) | 1.201 | (0.866, 1.665) | 0.272 | |
| Sex | Female | 114 (34.0) | Reference | Reference | Reference |
| Male | 221 (66.0) | 0.474 | (0.329, 0.683) | <0.001 | |
| T2DM | Normal | 243 (72.5) | Reference | Reference | Reference |
| T2DM | 92 (27.5) | 1.085 | 0.784, 1.500 | 0.623 | |
| HTN | Normal | 140 (41.8) | Reference | Reference | Reference |
| HTN | 195 (52.8) | 1.098 | (0.819, 1.472) | 0.533 | |
| eGFR | - | 0.966 | (0.941, 0.991) | 0.008 | |
| eGFR slope group | >－5 mL·(1.73 m2·min·year)-1 | 90 (26.9) | Reference | Reference | Reference |
| ≤－5 mL·(1.73 m2·min·year)-1 | 245 (73.1) | 3.369 | (2.046, 5.546) | <0.001 | |
| Scr | - | 1.007 | (1.001, 1.013) | 0.014 | |
| BUN | - | 1.112 | (1.084, 1.141) | <0.001 | |
| Alb group | ≥35 g/L | 158 (47.2) | Reference | Reference | Reference |
| <35 g/L | 177 (52.8) | 1.520 | (1.146, 2.015) | 0.004 | |
| TG group | <2.3 mmol/L | 259 (77.3) | Reference | Reference | Reference |
| ≥2.3 mmol/L | 76 (22.7) | 1.165 | (0.843, 1.611) | 0.355 | |
| UA group | Normal | 101 (30.1) | Reference | Reference | Reference |
| ≥ 420/360 μmol/L | 234 (69.9) | 0.748 | (0.542, 1.031) | 0.076 | |
| YSJZ | Non-exposed group | 248 (74.0) | Reference | Reference | Reference |
| Exposed group | 87 (26.0) | 0.567 | (0.384, 0.838) | 0.004 | |
Table 5 Results of cox multivariate regression analysis
| Characteristic | Number (%) | HR | 95% CI | P value | |
|---|---|---|---|---|---|
| Age group | <60 years | 226 (67.5) | Reference | Reference | Reference |
| ≥60 years | 109 (32.5) | 1.201 | (0.866, 1.665) | 0.272 | |
| Sex | Female | 114 (34.0) | Reference | Reference | Reference |
| Male | 221 (66.0) | 0.474 | (0.329, 0.683) | <0.001 | |
| T2DM | Normal | 243 (72.5) | Reference | Reference | Reference |
| T2DM | 92 (27.5) | 1.085 | 0.784, 1.500 | 0.623 | |
| HTN | Normal | 140 (41.8) | Reference | Reference | Reference |
| HTN | 195 (52.8) | 1.098 | (0.819, 1.472) | 0.533 | |
| eGFR | - | 0.966 | (0.941, 0.991) | 0.008 | |
| eGFR slope group | >－5 mL·(1.73 m2·min·year)-1 | 90 (26.9) | Reference | Reference | Reference |
| ≤－5 mL·(1.73 m2·min·year)-1 | 245 (73.1) | 3.369 | (2.046, 5.546) | <0.001 | |
| Scr | - | 1.007 | (1.001, 1.013) | 0.014 | |
| BUN | - | 1.112 | (1.084, 1.141) | <0.001 | |
| Alb group | ≥35 g/L | 158 (47.2) | Reference | Reference | Reference |
| <35 g/L | 177 (52.8) | 1.520 | (1.146, 2.015) | 0.004 | |
| TG group | <2.3 mmol/L | 259 (77.3) | Reference | Reference | Reference |
| ≥2.3 mmol/L | 76 (22.7) | 1.165 | (0.843, 1.611) | 0.355 | |
| UA group | Normal | 101 (30.1) | Reference | Reference | Reference |
| ≥ 420/360 μmol/L | 234 (69.9) | 0.748 | (0.542, 1.031) | 0.076 | |
| YSJZ | Non-exposed group | 248 (74.0) | Reference | Reference | Reference |
| Exposed group | 87 (26.0) | 0.567 | (0.384, 0.838) | 0.004 | |
Figure 2 Multivariable Cox regression forest plot analyzing factors influencing renal endpoint events The suffix "group" denotes that the variable is a grouping variable. Exposed group: basic treatment combined with Yishen Jiangzhuo granules intervention for more than 6 months; non-exposed group: basic treatment alone, or combined with Yishen Jiangzhuo granules treatment for less than 6 months. T2DM: type 2 diabetes mellitus; eGFR slope: estimated glomerular filtration rate slope; Scr: serum creatinine; BUN: blood urea nitrogen; UA: uric acid; Alb: albumin; TG: triglycerides. P < 0.05, statistically significant difference.
Figure 2 Multivariable Cox regression forest plot analyzing factors influencing renal endpoint events The suffix "group" denotes that the variable is a grouping variable. Exposed group: basic treatment combined with Yishen Jiangzhuo granules intervention for more than 6 months; non-exposed group: basic treatment alone, or combined with Yishen Jiangzhuo granules treatment for less than 6 months. T2DM: type 2 diabetes mellitus; eGFR slope: estimated glomerular filtration rate slope; Scr: serum creatinine; BUN: blood urea nitrogen; UA: uric acid; Alb: albumin; TG: triglycerides. P < 0.05, statistically significant difference.
Figure 3 ROC curve AUC: area under the ROC curve; ROC: receiver operating characteristic. AUC = 0.5: no predictive discrimination ability; AUC = 1: perfect classifier; AUC > 0.5: predictive discrimination ability; higher values indicate better performance.
Figure 3 ROC curve AUC: area under the ROC curve; ROC: receiver operating characteristic. AUC = 0.5: no predictive discrimination ability; AUC = 1: perfect classifier; AUC > 0.5: predictive discrimination ability; higher values indicate better performance.
Figure 4 Restricted cubic splines plot eGFR: estimated glomerular filtration rate; Red dots indicate restricted cubic splines nodes; P < 0.05 indicates statistically significant differences.
Figure 4 Restricted cubic splines plot eGFR: estimated glomerular filtration rate; Red dots indicate restricted cubic splines nodes; P < 0.05 indicates statistically significant differences.
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