中医辨证治疗对IgA肾病外周血调节性T细胞的影响  

Clinical Study on the Effect of TCM Syndrome Differentiation and Treatment on Peripheral Blood T Cell of IgAN

作　　者：耿嘉 王今朝 

机构地区：[1]黑龙江省中医药科学院,黑龙江哈尔滨150036

出　　处：《中医学报》2016年第2期266-268,共3页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(30973825)

摘　　要：目的:观察中医辨证治疗对Ig A肾病外周血调节性T细胞的影响。方法:将45例患者随机分为脾肾两虚组、气阴两虚组、肝肾阴虚组和健康对照组,每组15例。健康对照组不使用任何药物治疗;气阴两虚组,治宜益气养阴、清热利湿,方用清心莲子饮加减治疗;脾肾两虚组,治宜补肾健脾、清热利湿,方用参芪地黄汤加减;肝肾阴虚组,治宜滋补肝肾,清热利湿,方用六味地黄汤加减。共治疗3个月。结果:1各组患者治疗前、后尿蛋白定量和尿红细胞计数比较:与治疗前比较,气阴两虚组、肝肾阴虚组尿蛋白定量明显降低(P<0.05);脾肾两虚组尿蛋白定量较疗前也减低,但无统计学意义(P>0.05)。中医辨证治疗3个月后Ig A肾各组尿红细胞计数均较治疗前明显降低,差异有统计学意义(P<0.01)。2各组患者治疗前、后外周血CD_4^+、CD_(25)^+、叉头框蛋3(forkhead box protein,FOXp3)比较:治疗3个月后Ig AN各组外周血CD_4^+、CD_(25)^+、FOXp3较疗前明显降低,差异有统计学意义(P<0.05)。结论:Ig A肾病外周血调节性T细胞水平较正常人增高,中医辨证治疗可能通过降低外周血调节性T细胞水平从而有效治疗Ig A肾病。Objective ：To observe the effect of TCM Treatment on IgA nephropathy of regulatory T cells in peripheral blood. Methods ：45 patients were randomly divided into spleen and kidney deficiency group, Qi and Yin deficiency group,liver and kidney Yin deficiency group and healthy control group, 15 cases in each group. Healthy control group did not use any medication;Qi and Yin deficiency group was given replenishing Qi and nourishing Yin, clearing heat and removing dampness, with Qingxin Lianzi Yin; tspleen and kidney deficiency group was given tonifying kidney and spleen, clearing heat and removing dampness, with Shenqi Dihuang Tang;Yin deficiency of liver and kidney was given expelling heat and dampness, nourishing liver and kidney,with Liuwei Dihuang Tang, a total of 3 months. Results ：①compared with before treatment, urinary protein in the Qi and Yin deficiency group and liver and kidney Yin deficiency group significantly decreased （ P 〈 0.05 ） ; Urinary protein in the spleen and kidney deficiency group also decreased compared with before treatment, but there was no statistical significance （P 〉 0.05 ）. After TCM treatment for 3 months, IgA nephropathy urine RBC count in groups were lower than those before treatment,and the difference was statistically significant （ P 〈 0.01 ）.②After treatment for 3 months, IgAN each group peripheral blood CD4^＋ , CD25 ^＋ and forkhead box protein （ Foxp3 ） was significantly lower than before treatment, and the difference was statistically significant （ P 〈 0.05 ）. Conclusion ： IgA nephropathy in peripheral blood regulatory T cells level increased compared with normal person, and traditional Chinese medicine syndrome differentiation and treatment could treat of IgA nephropathy effectively possibly by reducing peripheral blood regulatory T cell level.

关 键 词：IGA肾病 脾肾两虚证 气阴两虚证 肝肾阴虚证 调节性T细胞 

分 类 号：R259.923.3[医药卫生—中西医结合]