益气固本调免方对IgA肾病患者外周血TGF-β_1表达的影响  

Effects of YiQi GuBen TiaoMian Prescription on the Expression of TGF-β_1 in Peripheral Blood of the Patients with IgA Nephropathy

作　　者：孟伟[1] 姜健[1] 沈沛成[1] 李雯雯[1] 梁婷玉[1] 何立群[1] MENG Wei;JIANG Jian;SHEN Peicheng;LI Wenwen;LIANG Tingyu;HE Liqun(Shanghai Shuguang Hospital Affiliated with Shanghai University of TCM,Shanghai 201203, China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《西部中医药》2018年第4期1-4,共4页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号81173219);上海市科委中医引导类项目(编号15401930100);中医临床重点项目(编号14401972203);上海市卫生和计划生育委员会科研课题(编号201440488);上海市中医药三年行动计划(编号ZYSNXD-CC-YJXYY和ZY3-JSFC-2-1029);上海市高级中西医结合人才培养项目(编号ZYSNXD012-RC-ZXY003);上海高校创新团队建设项目;国家临床重点专科建设项目;国家中医药管理局重点学科建设项目资助

摘　　要：目的:观察益气固本调免方对IgA肾病患者血转化生长因子β_1(TGF-β_1)的影响。方法:将85例IgA肾病(CKD1-4期)患者随机分为2组,观察组43例给予益气固本调免方治疗,对照组42例给予科素亚治疗,疗程4个月。观察2组治疗前后临床疗效,24小时尿蛋白定量,尿红细胞数,血TGF-β_1水平,平均动脉压及肾小球滤过率。结果:总有效率观察组为74.4%,对照组为42.9%,2组比较差异有统计学意义(P<0.05)。对照组24小时尿蛋白定量降低(P<0.05),观察组尿红细胞数和24小时尿蛋白定量显著降低(P<0.05),组间比较差异有统计学意义(P<0.05)。血TGF-β_1水平观察组显著降低,组内比较差异有统计学意义(P<0.05),对照组有降低趋势,但治疗前后比较差异无统计学意义(P>0.05);血TGF-β_1水平的改善显著优于对照组(P<0.05)。平均动脉压及肾小球滤过率,治疗前后2组间比较,差异无统计学意义(P>0.05)。血TGF-β_1水平变化与尿红细胞数(r=0.8342,P<0.01)、24小时尿蛋白定量(r=0.568 2,P<0.05)观察组呈正相关。结论:益气固本调免方能有效减少IgA肾病患者的血尿和蛋白尿,其机制可能与血TGF-β_1水平的变化相关。Objective： To observe the effects of Yi Qi Gu Ben Tiao Mian prescription on TGF-β1 of the patients with IgA nephropathy. Methods： All 85 patients with IgA nephropathy at CKD1-4 stages were randomly allocated to two groups, 43 cases in the observation group were treated by Yi Qi Gu Ben Tiao Mian prescription and 42 cases in the control group by Cozaar, and the course was four months. Glomerular filtration rate（GFR）, mean arterial pressure（MAP）, the level of TGF-β1, urine erythrolyle number, urinary prote in quabti fication with 24 hours, and clinical effect of both groups were observed. Results： Total effective rate of the observation group was 74.4%, higher than42.9% of the control group, and the difference had statistical meaning（P〈0.05）. 24 hours urinary protein quantification in the control group lowered（P〈0.05）, urinary erythrocyte count and 24 hours urinary protein quantification in the observation group reduced significantly（P〈0.05）, and the difference had statistical meaning between both groups（P 〈0.05）. The level of TGF-β1 decreased in the observation group notably（P〈 0.05）, it showed the tendency of lowering in the control group, while the difference had no statistical meaning（P〈 0.05）; the improvements of the level of TGF-β1 were superior to these of the control group remarkably（P〉0.05）. The difference had no statistical meaning in the comparison of MAP and GFR before and after treating between both groups（P〉0.05）, The change of the level of TGF-β1 was positively related to urinary erythrocyte count（r=0.834 2, P〈0.01） and 24 hours urinary protein quantification（r=0.568 2, P〈0.05） in the obsewation group. Conclusion： Yi Qi Gu Ben Tiao Mian prescription could effectively mitigate hematuria and proteinuria of the patients suffering IgA nephropathy, and its mechanism might be related to the changes of TGF-β1 level in the blood.

关 键 词：IGA肾病 转化生长因子Β1 益气固本调免方 

分 类 号：R692.3[医药卫生—泌尿科学]