益肾汤联合肾衰一体化治疗对慢性肾衰竭患者血清TGF-β1及PAI-1的影响  

Effects of Yishen Decoction Combined with Integrated Therapy for Chronic Renal Failure on Serum TGF-β1 and PAI-1 in Patients with Chronic Renal Failure

作　　者：黄龙虎 吴志平 余信之 江中涛 HUANG Long-Hu;WU Zhi-Ping;YU Xin-Zhi;JIANG Zhong-Tao(Wuhan Xinzhou District People’s Hospital of Hubei Province,Wuhan 430499 Hubei,China)

机构地区：[1]湖北省武汉市新洲区人民医院,湖北武汉430499

出　　处：《广州中医药大学学报》2022年第5期1033-1040,共8页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨益肾汤联合肾衰一体化治疗对慢性肾衰竭患者血清转化生长因子β1(TGF-β1)及纤溶酶原激活物抑制剂1(PAI-1)的影响。【方法】将128例慢性肾衰竭患者随机分为对照组和观察组,每组各64例。对照组给予肾衰一体化治疗,观察组给予益肾汤联合肾衰一体化治疗,疗程为2个月。观察2组患者治疗前后血清炎性细胞因子、肾功能指标、肾脏血流动力学指标、血管内皮生长因子(VEGF)、血清TGF-β1和PAI-1水平、中医证候积分和主观综合性营养评分以及生活质量健康调查简表(SF-36)评分的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗2个月后,观察组的总有效率为89.1%(57/64),对照组为70.3%(45/64),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的血清白细胞介素6(IL-6)、单核细胞趋化蛋白1(MCP-1)和细胞间黏附分子1(ICAM-1)水平均较治疗前明显降低(P<0.05),且观察组的血清IL-6、MCP-1和ICAM-1水平均明显低于对照组(P<0.01)。(3)治疗后,2组患者的血清肌酐(Scr)和尿素氮(BUN)水平均较治疗前明显降低(P<0.05),肌酐清除率(Ccr)水平均较治疗前明显升高(P<0.05),且观察组的血清Scr和BUN水平均明显低于对照组(P<0.01),Ccr水平明显高于对照组(P<0.01)。(4)治疗后,2组患者的血清VEGF、TGF-β1和PAI-1水平均较治疗前明显降低(P<0.05),且观察组的血清VEGF、TGF-β1和PAI-1水平均明显低于对照组(P<0.05或P<0.01)。(5)治疗后,观察组的肾动脉内径和肾动脉阻力指数均较治疗前明显改善(P<0.05),而对照组治疗前后比较,差异均无统计学意义(P>0.05);组间比较,观察组对肾动脉内径和肾动脉阻力指数的改善作用均明显优于对照组(P<0.01)。(6)治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),主观综合性营养评分均较治疗前明显提高(P<0.05),且观察组的中医证候积分明显低于对照组(P<0.01),主观�Objective To investigate the effects of Yishen Decoction combined with integrated therapy for chronic renal failure(CRF)on serum transforming growth factorβ1(TGF-β1)and plasminogen activator inhibitor 1(PAI-1)in CRF patients.Methods A total of 128 CRF patients were randomly divided into control group and observation group,with 64 cases in each group.The control group was given integrated therapy for CRF,and the observation group was given Yishen Decoction orally combined with integrated therapy for CRF.The course of treatment covered 2 months.Before and after treatment,we observed the changes in the levels of serum inflammatory cytokines,renal function indexes,vascular endothelial growth factor(VEGF),and serum TGF-β1and PAI-1,traditional Chinese medicine(TCM)syndrome scores,subjective comprehensive nutrition scores and the scores of each SF-36 dimensions in the two groups.After treatment,the therapeutic effect of the two groups was evaluated.Results(1)After 2 months of treatment,the total effective rate of the observation group was 89.1%(57/64),and that of the control group was 70.3%(45/64).The intergroup comparison showed that the total effective rate of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the levels of serum interleukin 6(IL-6),monocyte chemoattractant protein 1(MCP-1)and intercellular adhesion molecule 1(ICAM-1)in the two groups were significantly decreased in comparison with those before treatment(P<0.05),and the levels of serum IL-6,MCP-1 and ICAM-1 in the observation group were significantly lower than those in the control group(P<0.01).(3)After treatment,the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)in the two groups were significantly decreased and endogenous creatinine clearance rate(CCr)was increased in comparison with those before treatment(P<0.05).The serum levels of Scr and BUN in the observation group were significantly lower and Ccr was higher than those in the control group(P<0.01).(4)After treatment,the serum

关 键 词：慢性肾衰竭 益肾汤 肾衰一体化治疗 肾功能 血清转化生长因子Β1 血清纤溶酶原激活物抑制剂1 

分 类 号：R277.5[医药卫生—中医学]