四逆汤治疗急性马兜铃酸肾病的疗效研究  

Efficacy and mechanisms of Sini decoction on acute aristolochic acid nephropathy

作　　者：贾亚俊 高珊[2] 

机构地区：[1]长子县人民医院,山西长子046600 [2]天津医科大学总医院,天津300052

出　　处：《基层医学论坛》2016年第18期2538-2540,共3页The Medical Forum

摘　　要：目的观察四逆汤治疗急性马兜铃酸肾病的疗效。方法入选29例服用含木通汤药导致急性肾损伤患者,随机分为四逆汤组15例和一般治疗组14例。观察治疗前及治疗后4周、8周血清尿素氮、肌酐、尿NAG酶、尿糖等指标变化,测定尿氧化应激产物,比较肾功能恢复情况。结果治疗前2组血、尿指标差异无统计学意义(P>0.05)。治疗后4周,2组血清尿素氮、肌酐均较治疗前明显下降(P<0.05),且四逆汤组尿氧化应激产物、尿NAG酶、尿糖低于一般治疗组(P<0.05)。治疗8周,四逆汤组血清尿素氮、肌酐明显低于一般治疗组(P<0.05),但尿NAG酶、尿糖及尿氧化应激产物差异无统计学意义(P>0.05)。结论四逆汤可减轻肾组织氧化应激,而促进急性马兜铃酸肾病急性肾损伤患者的恢复。Objective To observe the effect of Sini decoction on acute aristolochic acid nephropathy.Methods Twenty-nine cases with acute kidney injury induced by large doses manshuriensis（more than 10 g/d）were randomly divided into 15 cases of SND group and 14 cases of general treatment group. Before and after treatment 4,8 weeks, serum urea,creatinine,urinary NAG enzyme,and urinary oxidative stress product in two groups were compared,and the relationship between urinary oxidative stress product and serum urea,creatinine,urinary NAG enzyme were analyzed.Results The serum urea,creatinine,urinary NAG enzyme,urine glucose and urinary oxidative stress product were not statistically significant between the two groups before treatment（P﹥0.05）. Four weeks later,the levels of serum urea and creatinine decreased significantly compared with the levels before treatment（P﹤0.05）,while no significant difference between the two groups（P﹤0.05）.However,the urine oxidative stress products,urinary NAG enzyme,urine glucose in SND group were significantly lower than the general treatment group,suggesting SND group recovery earlier. Eight weeks later,the levels of serum urea and creatinine in SND group were significantly lower than the general treatment group（P﹤0.05）,but the differences of urinary NAG enzyme,urine glucose and urinary oxidative stress products were no statistically significant（P﹥0.05）.Conclusion Sini decoction could alleviate oxidative stress in renal tubular cells and contribute to the restoration of acute aristolochic acid nephropathy in patients with acute kidney injury.

关 键 词：急性肾损伤 马兜铃酸肾病 四逆汤 氧化应激 

分 类 号：R277.5[医药卫生—中医学]