尿毒清颗粒对慢性肾脏病钙磷代谢及成纤维生长因子23的影响  

The Influence of Niaoduqing Particle on the Calcium and Phosphorus Metabolism and FGF23 in Patients with Chronic Kidney Disease

作　　者：叶敏媛 郑京[2] 张娟[2] 陈雪兰[2] 刘慈赟[1] 吴心虹[1] 刘亚芳[1] 

机构地区：[1]福建中医药大学,福建福州350100 [2]福建中医药大学附属人民医院

出　　处：《中国医学创新》2015年第23期16-18,共3页Medical Innovation of China

基　　金：福建省自然科学基金项目(2012J01378)

摘　　要：目的：探讨尿毒清颗粒对慢性肾脏病（CKD）3-5期钙、磷代谢及成纤维生长因子23（FGF23）水平的影响。方法：选择符合美国2002年K/DOQI CKD诊断标准3-5期患者54例,随机分为治疗组（尿毒清颗粒）和对照组,同时选取正常组20例。测定外周血中FGF23、全段甲状旁腺激素（i PTH）、尿素氮（BUN）、血肌酐（Scr）、Ca、P水平,以及尿肌酐水平;根据MDRD公式计算肾小球滤过率（GFR）。结果：随着GFR的下降,CKD3-5期患者的血P、FGF23、BUN、Scr较正常组均显著升高,血Ca较正常组显著下降,差异均有统计学意义（P〈0.01）。CKD3-4期：与治疗前比较,治疗组Scr下降显著（P〈0.05）,P、FGF23均显著下降（P〈0.01）,GFR显著提高（P〈0.01）,BUN下降但无显著差异（P〉0.05）;对照组FGF23显著下降（P〈0.05）,Scr下降、GFR提高,但均无显著差异（P〉0.05）;两组Ca均提高,无统计学意义（P〉0.05）;与对照组比较,治疗组的P、FGF23均显著下降（P〈0.05或P〈0.01）。CKD5期：与治疗前比较,治疗组GFR显著提高（P〈0.01）,Ca提高（P〈0.05）,两组的FGF23也下降（P〈0.05或P〈0.01）,BUN、Scr、P也下降,但无明显差异（P〉0.05）,对照组GFR提高,但无明显差异（P〉0.05）。结论：尿毒清颗粒具有改善患者钙、磷代谢以及FGF23水平的作用,且其可能通过改善血中钙、磷代谢水平,降低PTH、FGF23等因子的表达,从而延缓CKD-MBD的进展。Objective： To explore the influence of Niaoduqing （ NDQ ） Particle on the calcium, phosphorus and fihroblast growth factor 23 （ FGF23 ） in patients with CKD stage 3-5.Method： According to the standard of NKF-K/DOQI proposed, fifty- four CKD patients were randomly divided into the treatment group （ Niaoduqing Particle ） and the control group, at the same time, 20 cases were selected as the normal group.FGF23, iPTH, BUN, Scr, Ca, P levels and Ucr were determined, then GFR was calculated based on MDRD equation.Result： Compared with normal group, with the decline of GFR, the level of P, FGF23, BUN, Scr in the serum of the patients with CKD stage 3-5 were significantly increased, the level of Ca was significantly decreased, the differences were statistically significant （P〈0.01） .CKD stage 3-4： compared with the pretherapy, serum P, FGF23, Scr level were decreased （ P〈0.01 or P〈0.05 ）, GFR was increased （ P〈0.01 ） in the treatment group, there was no significant difference in BUN （ P〉0.05 ） .In the control group, FGF23 level was decreased （ P〈0.05 ）, Scr decreased and GFR increased, but there were no statistically significant differences （ P〉0.05 ） .Ca of the two groups were increased, but there had no statistical significances （ P〉0.05 ） .Compared with the control group, the P and FGF23 level of the treatment group were decreased significantly （P〈0.05 or P〈0.01 ） .CKD stage 5： compared with the pretherapy, GFR and Ca of the treatment group were significantly increased （ P〈0.O1 or P〈0.05 ）, FGF23 of the two groups were decreased （ P〈O.05 or P〈0.O1 ）, BUN, Scr, P decreased, but there were no statistically significant differences （ P〉0.05 ） .GFR of the control group was decreased, but there had no statistical significances （ P〉0.05 ） .Conclusion： Niaoduqing Particle can improve the levels of calcium, phosphorus and FGF23 of the patients, and it may play an important role to delay the progression of CKD-MBD by improvin

关 键 词：尿毒清颗粒 慢性肾脏病 钙、磷代谢 成纤维细胞生长因子23 甲状旁腺激素 

分 类 号：R692[医药卫生—泌尿科学]