用户名: 密码: 验证码:
益肾清利颗粒干预慢性肾小球肾炎肾虚湿热证的临床观察与动物实验
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
慢性肾小球肾炎(CGN),简称慢性肾炎,临床上以蛋白尿、血尿、高血压和水肿为基本表现。其起病方式各有不同,病情迁延,进展缓慢,终至慢性肾衰竭。本病中,肾虚湿热是慢性肾炎重要的病理特征,湿热既是致病因素,又是病理产物。益肾清利颗粒由黄芪、白术、山萸肉、杜仲、泽泻、白花蛇舌草等组成,全方补肾益气,清热利湿。故以益肾清利之法-益肾清利颗粒治疗慢性肾炎肾虚湿热证。
     一、益肾清利颗粒对于大鼠Heymann肾小球肾炎的作用
     以益肾清利颗粒、肾炎康复片治疗Heymann肾小球肾炎大鼠,测尿常规(尿蛋白、尿红细胞)、24小时尿蛋白定量、肾功能(肌酐、尿素氮)、肝功能(总蛋白、白蛋白)的水平及治疗前后的动态变化。结果表示:益肾清利颗粒显著减低24小时尿蛋白及肌酐,升高血清白蛋白;该药降低血清肌酐、升高血清白蛋白的作用优于肾炎康复片。
     二、益肾清利颗粒对于大鼠C-BSAⅠ肾小球肾炎的作用
     以益肾清利颗粒、肾炎康复片治疗C-BSAⅠ肾小球肾炎大鼠,检测尿常规(尿蛋白、尿红细胞)、24小时尿蛋白定量、肾功能(肌酐、尿素氮)、肝功能(总蛋白、白蛋白、胆固醇、甘油三酯)的水平及治疗前后的动态变化。结果表示:益肾清利颗粒可以降低24小时尿蛋白及血肌酐,对于白蛋白的降低趋势、胆固醇的升高趋势有一定改善作用。该药可显著降低胆固醇,效果早于、优于。肾炎康复片。
     三、益肾清利剂对慢性肾小球肾炎。肾虚湿热证患者的临床效果
     本文研究了16例慢性肾小球肾炎肾虚湿热证患者,给予常规治疗+益肾清利剂治疗,观察其中医症候、临床症状,检测尿常规(尿蛋白、尿红细胞)、24小时尿蛋白定量、肾功能(肌酐、尿素氮)、肝功能(总蛋白、白蛋白、胆固醇、甘油三酯)的前后变化。结果表明:治疗前后,其中医症候、临床症状显著改善,尿常规(尿蛋白、尿红细胞)、24小时尿蛋白定量等指标均显著降低。该药疗效显著,并可显著改善患者生存质量。
Chronic glomerulonephritis, abbreviated to chronic nephritis, hematuria, edema, high blood Pressure as the main clinical manifestation,different onset of ways, protracted, slow progressed, and eventually will be developed to the chronic renal failure. In this disease, Dampness-heat and Kidney deficiency is important pathologic characteristic of chronic nephritis.Dampness-heat is both pathogenic factor and pathological product. Yi shen qing li Granule is consists of astragalus membranaceus, atractylodes macrocephala koidz, cornus officinalis, eucommia, oriental waterplantain rhizome, hedyotis diffusa and other traditional chinese medicine,which clears away heat,promotes dampness and tonifies Qi of the kidney.Thus Yi shen qing li Granules treat chronic glomerulonephrit of Dampness-heat with Kidney deficiency syndrome with the method of tonifiying Qi of the kidney,clearing away heat and promoting dampness.
     A、Yi shen qing li Granule for the rats particles Heymann glomerulonephritis role
     To Yi shen qing li Granule, shenyan kangfu pian treatment Heymann glomerulonephritis rats, Testing routine urine (urine protein, urinary red blood cells),24-hour urinary protein quantitative, renal function (serum creatinine, urea nitrogen), liver function (total protein, albumin, cholesterol, triglyceride) and the dynamic changes between before and after treatment. The results said:Yi shen qing li Granule obviously decreases the particles24-hour urine protein and serum creatinine, increases serum albumin, this drug reduceing serum creatinine,and increasing the role of serum albumin is better than the nephritis of rehabilitation.
     B、Yi shen qing li Granule for the rats C-BSA glomerulonephritis role
     To Yi shen qing li Granule, shenyan kangfu pian treatment C-BSA glomerulonephritis rats, Testing routine urine (urine protein, urinary red blood cells),24-hour urinary protein quantitative, renal function (serum creatinine, urea nitrogen), liver function (total protein, albumin, cholesterol, triglyceride)l and the dynamic changes between before and after treatment. The results said:Yi shen qing li Granule can reduce24-hour urinary protein and serum creatininc, to reduce the trend of albumin, rising trend for cholesterol have improved.
     C、To observe the clinical effects of Yi shen qing li Granule In treating Patienis with Dampness-hot and Kidney deficiency syndrome in chronic glomerulonephritis.
     This paper studies16patients of syndrome of Dampness-hot and kidney deficiency of chronic glomerulonephritis,they are treated by routine treatment+Yi shen qing li Granule. Observe the TCM symptoms, the clinical symptoms, test routine urine (urine protein, urinary red blood cells),24-hour urinary protein quantitative, renal function (serum creatinine, urea nitrogen), liver function (total protein, albumin, cholesterol, triglyceride)l and the dynamic changes of the before and after treatment. The results show that:before and after treatment, the TCM symptoms, the clinical symptoms improved significantly, routine urine (urine protein, urinary red blood cells),24hour quantitative indices such as urinary protein were significantly reduced.
引文
[1]李明,贡涛,贾明聪,等.肾脏疾病住院病人2793例的流行病学[J].西川医学,2002,11,23(11):1130~1131
    [2]王向杰,周英杰,刘键,等.慢性肾衰竭2313例病因及首发表现临床分析[J].临床误诊误治,2011,12,24(12):11~13
    [3]向福坤,贺绍述,谭芳.80例慢性肾衰竭患者原发疾病分析[J].现代医药卫生,2005,21(11):1324-1325
    [4]张路霞,左力,徐国宾,等.北京市石景山地区中老年人群中慢性肾脏病的流行病学研究[J].中华肾脏病杂志,2006,22:67~71
    [5]程李涛.熊宁宁教授治疗慢性肾炎湿热证经验撷萃[J].中医药学刊,2003,3,21(3):3
    [6]王跃娟,孙伟.慢性肾小球肾炎患者中医证型分布及其演变规律初探[J].中国中西医结合肾病杂志,2009,5,10(5):440~442
    [7]金亚明,胡仲仪,沈玲妹.黄蜀葵花胶囊治疗慢性肾炎湿热症35例临床观察[J].浙江临床医药,2000,2(1):50
    [8]张红梅,陈雪功,王望九,等.慢肾蛋白停防治实验性慢性肾炎湿热证及对白细胞Fc受体的影响[J].辽宁中医杂志,2004,11(1):32—35
    [9]刘宝厚,甘培尚,杨扬.肾复康1号颗粒治疗慢性肾小球肾炎临床疗效观察[J].中国中西医结合肾病杂志2004,10,5(10):583-584.
    [10]包晓星,金伟民,张莉.肾炎口服液治疗慢性肾炎临床观察[J].实用中医药杂志2008,10,24(10):626-627
    [11]杨巧芳,董秋梅,麻春杰,等.朱宗元治疗慢性肾炎临证思辨特点探析[J].中国中医药信息杂志,2010,11,17(11):86-87
    [12]张春玲,苏秀文.曲生教授脾肾论学术思想介绍[J].长春中医药大学学报,2009,4,25(2):168~169
    [13]苏衍进,朱海慧.马居里教授治疗慢性肾炎经验总结[J].陕西中医学院学报,2011,7,34(4):24~25
    [14]吕芳,王亿平,王东,等.曹氏清补法治疗慢性肾炎60例临床观察[J].中医药临床杂志,2010,6,22(3):226~228
    [15]李波.夏翔教授“治慢性肾炎方”临证心得[J].中国中医药现代远程教育,2009,7,1(69):416~47
    [16]金华,张蕾.杨霓芝运用益气活血法治疗慢性肾炎的临床经验[J].辽宁中医杂志,2011,38(7):1283~1285
    [17]谢永祥,龙春莉.吴金玉论治慢性肾炎蛋白尿经验[J]. Chinese Journal of Information on TCM,2011,18 (5):90
    [18]田洋,陈路德,刘新瑞,等.李莹教授治疗慢性肾病学术经验继承与发微[J].中华中医药杂志,2011,6,26(6):1333-1335
    [19]Peveri P, Walz A, Dewald B, et al. Anovel neurophil activating factor produced by human mononucleac phagocytesJ Ex p Med,1988; 167:1547
    [20]Cunningham PN, WangY, Guo R, et al.Role ofToll-like receptor4 in endotoxin-induced acute renal failureJ Immuno,l 2004,172(4):2629-2635.
    [21]刘中柱,孔祥静,刘艳姝.黄葵胶囊对慢性肾小球肾炎患者血清Lkn-1和TNF-α水平影响的研究[J].中国中西医结合肾病杂志,2011,1,12(1):78-79
    [22]舒建.慢性肾炎患者治疗前后血清IL-2、 IL-10、 IL-18检测的临床意义[J].放射免疫学杂志,2011,24(5):533~534
    [23]舒建慢性肾炎患者治疗前后血清IL-2、 IL-10、 IL-18检测的临床意义,放射免疫学杂志,2011,24(5):533~534
    [24]高坤.孙伟教授以益肾清利活血法治疗慢性肾小球疾病的经验[J].江苏中医药,2004,25(11):19~20
    [25]程李涛.熊宁宁教授治疗慢性肾炎湿热证经验撷萃[J].中医药学刊,2003,3,21(3):3
    [26]汤溟.刘明教授从湿热论治慢性肾小球肾炎浅识[J].中医药学刊,2005,9,(9):79-81
    [27]李玉婷,蔡红凯,陈嘉,等.乐才文治疗慢性肾炎的经验拾零[J].光明中医,2007,3,22(3):20~21
    [28]刘宏伟.原发性肾小球疾病肾小球内补体成分测定与中医辨证分型的关系[J].辽宁中医杂志,1993.,3:1~2
    [29]张福生,杨颖.慢性肾炎湿热证客观指标的变化[J].浙江中医杂志,1995,30(7)322~323
    [30]盛梅笑,孙伟,贾宁人,等.肾炎湿热证血清sICAM-1变化的临床观察[J].辽宁中医杂志,2003,330(11):891~892.
    [31]朱辟疆,施荣华,刘永平.慢性肾小球疾病湿热证血浆及尿白介素-6的改变[J].浙江中西医结合杂志,1999,9(2):75-77.
    [32]朱莺,孙伟.孙伟治疗慢性肾炎对药应用经验撷著[J].辽宁中医杂志,2007,34(5):564~565
    [33]窦志强.戴恩来教授从湿热论治慢性肾炎蛋白尿经验[J].甘肃中医,2008,12(2):9~10
    [34]郭连川.分型辨治慢性肾炎36例[J].辽宁中医杂志,2000,27(2):89
    [35]张福产,陈岱.张志坚治疗慢性肾炎的经验[J].江苏中医药,2009,41,(11):9-11
    [36]金亚明,胡仲仪,沈玲妹.黄蜀葵花胶囊治疗慢性肾炎湿热症35例临床观察[J].浙江 临床医药,2000,2(1):50
    [37]张红梅,陈雪功,王望九,等.慢肾蛋白停防治实验性慢性肾炎湿热证及对白细胞Fc受体的影响[J].辽宁中医杂志,2004,11(1):32~35
    [38]刘宝厚,甘培尚,杨扬.肾复康1号颗粒治疗慢性肾小球肾炎临床疗效观察[J].中国中西医结合肾病杂志2004,10,5(10):583~584.
    [39]戴京璋.吕仁和教授治疗慢性肾炎经验[J].新中医,2001,6,33,(6):9~10
    [40]杨雪花,冯松杰.柴苓汤治疗慢性肾小球肾炎53例[J].辽宁中医学院学报,2005,1,7,(1):53-54
    [41]陈学英.肾小球肾炎湿热证治疗体会[J].江西中医药2005,11,11,36(275):48~49
    [42]成秉林,张淑君.牡垢泽泻散加减治疗慢性肾炎[J].黑龙江中医药,2000(3):33~34
    [43]马红岩.杨霓芝治疗慢性肾炎经验介绍[J].中国中医药信息杂志,2008,7,15(7):88~92
    [44]刘慰祖.著名老中医徐高年辫证治疗慢性肾炎的经验[J].上海中医药杂志,1982,(11):5~7
    [45]周恩超.王钢治疗慢性肾小球肾炎经验[J].中医杂志,,2001,10,42,(10):590~591
    [46]孔庆歆.陆鸿滨教授治疗肾炎重清利而慎温补的经验介绍[J].新中医2003,6,35(6):16~17
    [47]孙成考,卞耀臣,黄芪皂苷注射液对糖尿病肾病血管内皮细胞功能保护临床研究[J],辽宁中医药大学学报,2008,5,10(5):79~80
    [48].牟姗,王琴,施蓓莉等,高汤对肾小管上皮细胞胶原分泌和PAI-1合成的影响以及黄芪调控作用[J],中国中西医结合肾病杂志,2009,1,10(1):11~14
    [49]魏佳莉,王畅,彭佑铭等,黄芪对人肾小管上皮细胞细胞外基质分泌的影响及其机制探讨[J],中国中西医结合肾病杂志,2009,8,10(8):664~667
    [50]张国珍,吴小川,彭晓杰等,黄芪对实验性IgA肾病大鼠肾小管间质损害及NF-κBMCP-1表达的影响[J],中国当代儿科杂志,2008,4,10(2):173~178
    [51]周德文.术类的药理和药效[J].国外医药·植物药分析,1996,11(33):120~122
    [52]毛俊伟,吕志良,曾群力,等.白术多糖对小鼠淋巴细胞功能的调节[J].免疫学杂志,1996,12(4):233~236
    [53]Bottinger EP. BitzerM. TGF-betasi gnalinginrenaldisease[J]. AmSocNephrol,2002. 13(10):2600-2610.
    [54]Derynck R. Zhang YE. Smad-dependentand Smad-independent pathways in TGF-beta familysignalling[J]. Nature. 2003,425(6958):577-584.
    [55]Liu Y. Renalfibrosis:Newinsi ghtsintothe pathogenesismzl therapeutics[J]. Kidney Int.2006. 692:213-217
    [56]程虹,宋恩峰.杜仲对UUO模型大鼠肾纤维化TGF-β 1/Smad信号通路的影响[J].中国中西医结合.肾病杂志,2009,6,10(6):502~504
    [57]李建民,周勇,项静辰,等.山茱萸总苷对正常小鼠T淋巴细胞免疫功能影响的实验研究[J].北京中医药大学学报,2000,11,23(6):30~32
    [58]张春海,毛缜,马丽,等.泽泻水提取物、醇提取物对小鼠脂代谢影响的比较[J].徐州师范大学学报(自然科学版),2005,23(2):68
    [59]尹春萍,吴继洲.泽泻及其活性成分免疫调节作用研究进展[J].中草药,2001,32(12)1132
    [60]王宇翎,张艳,方明,等.白花蛇舌草总黄酮的免疫调节作用[J].中国药理学通报,2005,8,21(4):444~447
    [61]吴金英,贾占红,孙建宁,等.复方石韦片主要药效的实验研究[J].浙江实用医学,2005,10(5):311~313
    [62]张国强,叶任高,孔庆瑜,等.三七总苷诱导间质纤维化人肾成纤维细胞凋亡及其分子机理初探[J].中华肾脏病杂志,1998,4,14(2):93~95
    [63]王宓,樊均明,刘欣颖,等.三七总皂甙对IL-1α诱导大鼠肾小管细胞转分化的影响[J].中国中西医结合杂志,2004,24(8):722-725.
    [64]王立新,杨霓芝,包昆.通脉口服液对系膜增殖性肾炎大鼠血液流变学的影响[J].中医药研究,2001,17(1):42-43
    [65]陈伟栋,肾炎康复片治疗慢性肾炎的疗效观察[J],湖北中医杂志,2012,2,34(2):15-16
    [66]邵世宏,尹宝莲.肾炎康复片临床应用综述[J].中国中西医结合肾病杂志,2001,9(2):141
    [67]张光明,郭东阳,景宇.肾炎康复片治疗隐匿性肾炎单纯血尿疗效观察[J].现代医学,2009,25(15):2250
    [68]叶婷婷,沈建明,邓妍妍,等.肾炎康复片对大鼠肾间质纤维化的保护作用[J].郧阳医学院学报,2008,10,27(5):401~403
    [69]辛小龙,王静.肾炎康复片对慢性肾小球肾炎免疫功能的影响[J].中国中西医结合肾病杂志,2011,10,12(10):913~914
    [70]中华人民共和国卫生部药典委员会.中华人民共和国药典(一部)[S].1995:389.
    [71]Border WA, etal. I nduct ion of membranous nephropathyin rabbits by administration of an exogenous cationicantigen. J clin Invest,1982,68:451
    [72]梁静,孙兴旺,曹灵,等.不同剂量阳离子化牛血清白蛋白对膜性肾病大鼠造模的影响[J].中国组织工程研究与临床康复,2008,09,09,12(37):7322~7325
    [73]刘刚,马序竹,邹万忠,等.肾活检患者肾脏病构成十年对比分析[J].临床内科杂志, 2004,21:834~838
    [74]Cybulsky AV, Takano T, Papillon J, et al. Activation of the extrace12ular signal regulated kinase by complement C5b-9[J].Am J PhysiolRenal Physiol,2005,289 (3):F5932603.
    [75]Rennke HG&Venkoteh Jam Glomerulor permeability:invivotraeor studies with polyannic and polycationnic ferritins[J].Kidney Int 1977,11:44
    [76]Furness PN Turner DR. An assessment of the influence of antigen dose in two new models of chronic serum sick-ness nlomerulonephritis in the rat.BrJ Exp Pathol 1987,68:527

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700