补肾祛瘀活血汤联合氯沙坦治疗气虚血瘀型慢性肾小球肾炎疗效及对血清Cys-C、α1-MG水平和T淋巴细胞亚群的影响  

Curative effect of Bushen Quyu Huoxue Decoction combined with losartan on chronic glomerulonephritis of qi-deficiency blood stasis type and its influences on serum Cys-C,α1-MG and T lymphocyte subsets

作　　者：熊媛媛 李莎 莫怡浩 刘佳栋 XIONG Yuanyuan;LISha;MO Yihao(Department of Nephrology,Shenzhen Longhua People's Hospital,Shenzhen Guangdong 518110,China)

机构地区：[1]深圳市龙华区人民医院肾内科,广东深圳518110 [2]黄石市中心医院(湖北理工学院附属医院)医学检验科,湖北黄石435000

出　　处：《四川中医》2023年第5期136-140,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨补肾祛瘀活血汤联合氯沙坦治疗气虚血瘀型慢性肾小球肾炎(CGN)疗效及对血清胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)水平和T淋巴细胞亚群的影响。方法:选取2020年3月~2022年3月本院收治的136例气虚血瘀型CGN患者,采用随机数字表法分为联合组68例和西药组68例。西药组采用氯沙坦治疗,联合组在西药组的基础上联合补肾祛瘀活血汤治疗,两组均连续治疗3个月。治疗结束后,比较两组临床疗效。比较两组治疗前后中医证候积分、肾功能指标[24h尿蛋白定量(UPQ)、血清肌酐(Cr)、尿素氮(BUN)、Cys-C、α1-MG]和T淋巴细胞亚群变化。结果:治疗后,联合组总有效率(95.59%)高于西药组(83.82%),差异具有统计学意义(P<0.05)。治疗后,两组患者中医证候积分及24h UPQ、血清Cr、BUN、Cys-C、α1-MG较治疗前下降(P<0.05),且联合组中医证候积分及24h UPQ、血清Cr、BUN、Cys-C、α1-MG较低(P<0.05)。治疗后,两组患者CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)较治疗前上升、CD_(8)^(+)较治疗前下降(P<0.05),且联合组CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)较高、CD_(8)^(+)较低(P<0.05)。结论:补肾祛瘀活血汤联合氯沙坦治疗气虚血瘀型CGN,可改善患者肾功能,有效下调血清Cys-C、α1-MG表达水平,增强机体免疫功能,提高患者临床疗效。Objective:This study aims to investigate the efficacy of Bushen Quyu Huoxue Decoction combined with losartan in the treatment of chronic glomerulonephritis(CGN)of qi-deficiency blood stasis type,as well as its effects on serum cystatin C(Cys-C),α1-microglobulin(α1-MG),and T lymphocyte subsets.Methods:A total of 136 patients with CGN of qi-deficiency blood stasis type,who were admitted to the hospital between March 2020 and March 2022,were enrolled in this study.These patients were randomly divided into two groups:the combined group(n=68),who received both Bushen Quyu Huoxue Decoction and losartan,and the western medicine group(n=68),who received only losartan.After three months of continuous treatment,the clinical efficacy,changes in TCM syndrome scores,renal function indexes including 24-hour urine protein quantification(UPQ),serum creatinine(Cr),blood urea nitrogen(BUN),Cys-C,α1-MG,and T lymphocyte subsets were compared between the two groups.Results:The total response rate in the combined group was significantly higher than that in the western medicine group(95.59%vs.83.82%,P<0.05).After treatment,the TCM syndrome scores,levels of 24-hour UPQ,serum Cr,BUN,Cys-C,andα1-MG in both groups were significantly decreased(P<0.05).Furthermore,these indicators were significantly lower in the combined group than in the western medicine group(P<0.05).After treatment,the CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)T lymphocyte subsets were significantly increased,while CD_(8)^(+)was significantly decreased in both groups(P<0.05).Additionally,the CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)T lymphocyte subsets in the combined group were significantly higher than those in the western medicine group,while CD_(8)^(+)was significantly lower(P<0.05).Conclusion:The combination of Bushen Quyu Huoxue Decoction and losartan can effectively improve renal function,down-regulate the expression levels of serum Cys-C andα1-MG,enhance immune function,and improve the clinical efficacy in patients with CGN of qi-deficiency blood stasis type.

关 键 词：慢性肾小球肾炎 气虚血瘀型 补肾祛瘀活血汤 氯沙坦 胱抑素C α1-微球蛋白 

分 类 号：R692.3[医药卫生—泌尿科学]