健脾益肾活血方对慢性肾炎患者BUN、SCR、LN、Ⅳ-Col、TNF-α的影响
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摘要
目的:观察健脾益肾活血方对慢性肾炎患者疗效及血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCR),层粘连蛋白(laminin,LN)、Ⅳ型胶原(tyPeⅣcollagen,Ⅳ-Col)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的影响。方法:将58例慢性肾炎患者随机分为对照组和治疗组各29例。对照组患者给予低盐低脂饮食以及控制血压、血脂等常规治疗,治疗组在对照组治疗的基础上采用健脾益肾活血方治疗,观察对比两组患者临床治疗疗效和BUN、SCR、LN、Ⅳ-Col、TNF-α的变化。结果:对照组有效率为62.07%,治疗组有效率为86.21%。两组有效率比较,差异有统计学意义(P<0.05);两组治疗后中医证候积分、24 h尿蛋白定量均较治疗前减少(P<0.05),组间比较有统计学意义(P<0.05);两组患者治疗后BUN、SCR均较治疗前明显降低(P<0.05),组间比较差异有统计学意义(P<0.05);两组慢性肾炎患者治疗后血清LN、Ⅳ-Col、TNF-α均下降(P<0.05),组间比较治疗组低于对照组(P<0.05)。结论:健脾益肾活血方可有效降低慢性肾炎患者尿蛋白,改善肾功能,其机制可能与改善慢性肾炎患者肾纤维化、调节免疫因子有关。
Objective:To observe the clinical curative effect of Jianpi Yishen Huoxue Decoction(JPYSHXD) and its influence on blood urea nitrogen(Bun),serum creatinine(Scr),laminin(LN),type Ⅳ collagen(Ⅳ-Col)tumor necrosis factor-α(TNF-α)of patients with chronic nephritis.Methods:Fifty-eight patients with chronic nephritis were randomly divided into the control group and the treatment group,with 29 cases in each group.Patients in the control group were given low-salt and low-fat diet and routine treatment such as blood pressure control and blood lipid control.The ones in the treatment group were treated with JPYSHXD on the basis of the treatment in the control group.The clinical efficacies and changes of renal function,LN,Ⅳ-Col and TNF-α in the two groups were observed and compared.Results:The effective rate was 62.07% in the control group and 86.21% in the treatment group.The effective rate of the two groups was significantly different(P<0.05).After the treatment,the scores of TCM syndromes and 24-hour urinary protein in the two groups were decreased compared with those before the treatment,and the differences had statistical significance between the two groups(P<0.05).After the treatment,BUN and Scr in both groups were significantly lower than those before the treatment(P<0.05),and there was a significant difference between the two groups(P<0.05).After the treatment,serum LN,Ⅳ-Col and TNF-α in both groups were decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).Conclusion:JPYSHXD can effectively reduce urinary protein and improve renal function in patients with chronic nephritis.Its mechanism may be related to improving renal fibrosis and regulating immune factors in patients with chronic nephritis.
Objective:To observe the clinical curative effect of Jianpi Yishen Huoxue Decoction(JPYSHXD) and its influence on blood urea nitrogen(Bun),serum creatinine(Scr),laminin(LN),type Ⅳ collagen(Ⅳ-Col)tumor necrosis factor-α(TNF-α)of patients with chronic nephritis.Methods:Fifty-eight patients with chronic nephritis were randomly divided into the control group and the treatment group,with 29 cases in each group.Patients in the control group were given low-salt and low-fat diet and routine treatment such as blood pressure control and blood lipid control.The ones in the treatment group were treated with JPYSHXD on the basis of the treatment in the control group.The clinical efficacies and changes of renal function,LN,Ⅳ-Col and TNF-α in the two groups were observed and compared.Results:The effective rate was 62.07% in the control group and 86.21% in the treatment group.The effective rate of the two groups was significantly different(P<0.05).After the treatment,the scores of TCM syndromes and 24-hour urinary protein in the two groups were decreased compared with those before the treatment,and the differences had statistical significance between the two groups(P<0.05).After the treatment,BUN and Scr in both groups were significantly lower than those before the treatment(P<0.05),and there was a significant difference between the two groups(P<0.05).After the treatment,serum LN,Ⅳ-Col and TNF-α in both groups were decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).Conclusion:JPYSHXD can effectively reduce urinary protein and improve renal function in patients with chronic nephritis.Its mechanism may be related to improving renal fibrosis and regulating immune factors in patients with chronic nephritis.
引文
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[11] 袁红霞,张莉芹,马瑾,等.水蛭药用成分及主要药理功效研究进展[J].甘肃医药,2013,32(4):270-273.
[12] 孔薇,郑艳辉,张艳茹,等.益肾清利方对慢性肾炎肾虚湿热证患者TNF-α、IL-6、IL-10影响的研究[J].辽宁中医杂志,2017,44(5):999-1000.
[13] VALLES G,PEREZ C,BORE A,et al.Simvastatin prevents the induc-tion of interleukin-6 gene expression by titanium particles in human osteoblastic cells[J].Acta Biomater,2013,9(1):4916-4925.
[14] 刘雨清,张伟栋,郭爱华,等.肿瘤坏死因子在人膜增生性肾小球肾炎中的表达[J].中国现代医学杂志,2002,12(6):20-21.
[2] 吴玥露,孔薇.白细胞介素-6在慢性肾小球肾炎中的作用研究[J].西部中医药,2012,25(11):113.
[3] 车建强.系膜增生性肾小球肾炎患者血清IL-6、IL-10、IL-13的检测及其临床意义[J].中国实用医药,2012,7(25):129.
[4] 蔡旭,邱艳娥.慢性肾炎患者血清IL-2、IL-6、TNF-α水平变化及意义分析[J].中国医学创新,2013,10(6):8-9.
[5] 严冰.严冰中医文集[M].北京:中医古籍出版社,2012:46.
[6] 中华中医药学会肾病分会.慢性肾小球肾炎的诊断、辨证分型及疗效评定(2006 年)[J].上海中医药杂志,2006,40(6):8-9.
[7] 郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:233-247.
[8] DUBIN R,CUSHMAN M,FOLSOM A R,et al.Kidney function and multiple hemostatic markers:cross sectional associations in the multi-ethnic study of atherosclerosis[J].BMC Nephrol,2011,12(1):3.
[9] 姜楠.浅析洛汀新与黄芪联合治疗慢性肾炎的临床效果[J].中国医药指南,2016,14(35):137-138.
[10] 马益峰.黄芪注射液联合阿托伐他汀治疗慢性肾炎临床疗效分析[J].吉林医学,2015,36(14):2096-2099.
[11] 袁红霞,张莉芹,马瑾,等.水蛭药用成分及主要药理功效研究进展[J].甘肃医药,2013,32(4):270-273.
[12] 孔薇,郑艳辉,张艳茹,等.益肾清利方对慢性肾炎肾虚湿热证患者TNF-α、IL-6、IL-10影响的研究[J].辽宁中医杂志,2017,44(5):999-1000.
[13] VALLES G,PEREZ C,BORE A,et al.Simvastatin prevents the induc-tion of interleukin-6 gene expression by titanium particles in human osteoblastic cells[J].Acta Biomater,2013,9(1):4916-4925.
[14] 刘雨清,张伟栋,郭爱华,等.肿瘤坏死因子在人膜增生性肾小球肾炎中的表达[J].中国现代医学杂志,2002,12(6):20-21.