中西医结合疗法对慢性肾衰竭患者肿瘤坏死因子α及纤溶酶原激活物抑制物1的干预作用  

Effect of combined therapy of Chinese and Western medicine on TNF-α and PAI-1 in patients with chronic renal failure

作　　者：胡蜀宾 赵雯红[1] 张金楠[2] 张国瑛[1] 左建娇[1] 

机构地区：[1]河北省石家庄市中医院肾内科 [2]中国人民解放军93437部队医院化验室

出　　处：《河北中医》2013年第6期858-860,869,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2012年度中医药类科研计划课题(编号:2012160)

摘　　要：目的观察中西医结合疗法对慢性肾衰竭(CRF)患者血清肿瘤坏死因子α(TNF-α)、血浆纤溶酶原激活物抑制剂-1(PAI-1)的影响,旨在初步揭示此方法对CRF的可能干预途径。方法将120例慢性肾脏病(CKD)4期患者随机分为4组,各30例。西药组(A组)给予单纯常规治疗,西药+中药组(B组)在西药组基础上加中药汤剂补脾益肾活血降浊方加减,西药+中药+中药灌肠组(C组)在西药加中药组基础上加中药灌肠方,西药+中药+中药灌肠+中药熏蒸组(D组)在西药加中药加中药灌肠组基础上加中药熏蒸外洗法。4组疗程均为3个月,分别检测各组治疗前后血肌酐(Cr)、尿素氮(BUN)、TNF-α和PAI-1水平变化。结果治疗前后比较,A组血清肌酐、尿素氮及TNF-α差异无统计学意义(P>0.05),PAI-1水平降低(P<0.05);B、C、D组治疗前后比较,血清肌酐、尿素氮、TNF-α及血浆PAI-1水平均降低(P<0.01)。治疗后,与A组比较,B、C、D组血清肌酐、尿素氮、TNF-α及血浆PAI-1水平均降低(P<0.05);与B组比较,C、D组尿素氮均降低(P<0.05),D组血清肌酐降低(P<0.01),血清TNF-α、血浆PAI-1均无统计学意义(P>0.05);与C组比较,4组血清肌酐降低(P<0.05),尿素氮、血清TNF-α及PAI-1均无统计学意义(P>0.05)。结论中西医结合疗法可通过改善患者微炎症状态及纤溶活性,从而延缓CRF进展。Objective To investigate the effects of combined therapy of Chinese and Western medicine on TNF - α and plasminogen activator inhibitor（ PAI - 1 ） in patients with chronic renal failure. Methods The patients of chronic renal failure were randomly divided into 4 groups （ 30 cases in each group）. Patients in group A received conventional western medicine. Patients in group B received conventional western medicine combined with herbal soup. Patients in group C received medicine enema on the basis of group B treatment. Patients in group D received medical fumigation on the basis of group C treatment. The course was three months in all groups. The changes of levels of serum creatinine, blood urea nitrogen, TNF -α and PAI- 1 were measured before and after treatment. Results There was no significant difference between before and after treatment on the levels of serum creatinine, blood urea ni- trogen and TNF - α in group A（ P 〉 0. 05 ）. The level of PAI- 1 was decreased（ P 〈 0.05 ）. Compared with those be- fore treatment, the levels of serum creatinine, blood urea nitrogen,TNF - α and PAl - 1 were decreased after treatment in group B,C and D（P 〈0.01 ）. The levels of serum creatinine,blood urea nitrogen,TNF - α and PAI- 1 in group B, C and D were decreased as compared with those in group A after treatment （ P 〈 0.05 ）. Compared with those ingroup B, the level of blood urine nitrogen in group C and D was decreased（ P 〈 0.05 ） , serum ereatinine was decreased in group D （ P 〈 0.01 ）, there were no significant differ- ences between group B, C and D on the levels of TNF - α and PAl - 1 （ P 〉 0.05 ）. Compared with those in group C, the level of serum creatinine in group D was decreased （P 〈 0.05 ）, there were no significant differences betweengroup C and D on the levels of blood urea nitrogen, TNF - α and PAI- 1 （ P 〉 0.05 ）. Conclusion Combined thera- py of Chinese and western medicine could intervene CRF by inhibiting micro inflammatory state and modulatin

关 键 词：肾功能衰竭 慢性 中西医结合疗法 肿瘤坏死因子Α 纤溶酶原激活物抑制物1 

分 类 号：R452[医药卫生—治疗学] R244.9[医药卫生—临床医学]