清肾颗粒对湿热型慢性肾衰竭急剧加重患者血浆P-选择素及细胞间黏附分子-1的干预作用  

Effect of Qingshen Granule on Plasma P-selectin and Intercelluar Adhesion Molecule-1 in Patients with Sharp Deteriorated Chronic Renal Failure of Damp-heat Syndrome Type

作　　者：王亿平[1] 王东[1] 程皖[1] 胡顺金[1] 吕勇[1] 刘玲[1] 赵莉[1] 

机构地区：[1]安徽中医学院第一附属医院肾内科,合肥230031

出　　处：《中国中西医结合杂志》2009年第11期982-985,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：安徽省科技厅重点资助项目(No.05023087)

摘　　要：目的观察湿热型慢性肾衰竭(chronic renal failure,CRF)急剧加重患者血浆P-选择素(CD62P)、细胞间黏附分子-1(ICAM-1)水平及清肾颗粒的干预作用。方法60例湿热型CRF急剧加重患者随机分为治疗组和对照组,每组各30例,并选取20名健康体检者作为健康组。治疗组与对照组均在西药常规治疗同时使用中药解毒泄浊Ⅱ号保留灌肠,治疗组加用清肾颗粒,每次1袋(20g),每日3次口服,疗程1个月。检测两组临床疗效及治疗前后血浆CD62P、ICAM-1水平变化情况,并与健康组比较。结果治疗组临床疗效和中医证候疗效总有效率[均为90·0%(27/30)]明显高于对照组[60·0%(18/30)和63·3%(19/30)](P<0·05)。两组患者治疗前血浆CD62P、ICAM-1水平明显高于健康组(P<0·01);治疗后两组此二指标水平均下降(P<0·05),且治疗组下降幅度大于对照组(P<0·05)。结论湿热型CRF急剧加重患者血浆CD62P、ICAM-1水平较正常人组明显升高,清肾颗粒合用中药解毒泄浊Ⅱ号保留灌肠及常规西药较未使用清肾颗粒者可显著降低其水平,改善肾功能,减轻临床症状。Objective To observe the plasma levels of p-selectin（CD62P） and intercellular adhesion molecule-1 （ ICAM-1 ） in patients with sharp deteriorated chronic renal failure （CRF） of damp-heat syndrome type （ DHS）, and the curative efficacy of Qingshen Granule （QSG） on the disease. Methods Sixty cases with sharp deteriorated CRF of DHS were equally randomized to the treated group and the control group, all were treated with conventional Western medical therapy combining with retention enema of Jiedu Xiezhuo No. 11 ; but for patients in the treated group, QSG was given additionally, 1 bag thrice a day by oral intake. The therapeutic course for all was 1 month. Besides, a group of 20 healthy persons was set up for normal control. Plasma levels of CD82 P and ICAM-1 were measured before and after treatment, and were compared with those in the normal control. Results Both the total effective rate on disease and on Chinese medicine syndrome in the treated group were 90.0% （27/30）, significantly higher than those in the control group, 60.0% （18/30） and 63.3% （19/30）, re- spectively, showing significant differences between groups （P 〈 0.05）. Plasma levels of CD62 P and ICAM-1 were obviously higher before treatment as compared to those in the normal control group （ P 〈 0.01 ）, which reduced markedly after treatment in both treated group and control group （ P 〈 0. 05）, but the changes in the trea- ted group were more significant （ P 〈 0.05）. Conclusions Patients with sharp deteriorated CRF of DHS show higher plasma levels of CD82P and ICAM-1 in comparing with the normal control. Treatment of retention enema with QSG in combined with JDXZ No. Ⅱ could reduce the two indexes more significantly than that using retention enema alone, and the combined therapy could also improve renal function and ameliorate clinical symptoms in patients.

关 键 词：慢性肾功能衰竭 急剧加重 湿热型 血浆P-选择素 细胞间黏附分子-1 清肾颗粒 

分 类 号：R277.5[医药卫生—中医学]