黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者CRP和TNF-α及血液流变学的影响  

Study on the effect of Huangqi Xilingpi Decoction combined with Huoxuetongmai Tablet in the treatement of hypercoagulant of nephrotic syndrome on serum C-reactive protein,tumor necrosis factor-α and hemorheology

作　　者：段学峰[1] 王双珠[1] 叶华茂[1] 杨海华[2] 陈德君[1] 厉春萍[1] DUAN Xue-feng;WANG Shuang-zhu;YE Hua-mao(Department of Nephrology , Taizhou Hospital, Linhai , Zhejiang 317000, China)

机构地区：[1]浙江省台州医院肾内科,浙江临海317000 [2]浙江省台州医院放疗科

出　　处：《中华全科医学》2018年第7期1121-1124,共4页Chinese Journal of General Practice

基　　金：2015年浙江省医药卫生科技计划项目(2017KYA240)

摘　　要：目的探讨黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者血清CRP、TNF-α及血液流变学的影响。方法收集2014年3月—2016年2月于浙江省台州医院住院或门诊治疗的肾病综合征高凝血症患者78例,按随机数字表法分为2组,每组39例,对照组采用强的松、低分子肝素钙治疗;观察组在此基础上采用黄芪仙灵脾汤联合活血通脉片治疗,共治疗2个月为1个疗程,对比2组间临床疗效,治疗前后血液流变学、CRP、TNF-α、NO、ET-1以及肾功能指标,同时记录不良反应事件。结果与治疗前比较,2组治疗后红细胞压积、红细胞聚集指数、全血黏度、血浆黏度降低,血清CRP、TNF-α、ET-1降低,血清NO升高,24 h Pro、BUN、Scr水平降低,总蛋白水平升高(均P<0.05);与对照组比较,观察组治疗后红细胞压积、红细胞聚集指数、全血黏度、血浆黏度较低,血清CRP、TNF-α、ET-1较低,血清NO较高,24 h Pro、BUN、Scr水平较低,总蛋白水平较高(均P<0.05);对照组不良反应发生率(17.95%)与观察组(23.08%)对比差异无统计学意义(P>0.05)。结论黄芪仙灵脾汤联合活血通脉片对肾病综合征高凝血症患者疗效确切,且不增加不良反应,与降低CRP、TNF-α,改善血管内皮和血液流变学相关。Objective To investigate the effects of Huangqi Xianlingpi decoction combined with HXTMT syndrome in pa- tients with high serum CRP on the coagulation effect of nephropathy, TNF-alpha and blood rheology. Methods From March, 2014 to February, 2016, in our hospital inpatient or outpatient treatment of nephrotic syndrome in patients with high blood coagulation in 78 cases, were randomly divided into 2 groups, 39 cases in each group, the control group was given prednisone, low molecular weight heparin treatment, observation group on the basis of Huangqi Xianlingpi Decoc- tion Combined with Huoxue Tongmal tablet the treatment, were treated for 2 months for a course of treatment, compared the clinical efficacy of the two groups before and after treatment, blood rheology, CRP, NO, TNF-α, ET-1 and renal function index, and record adverse events. Results Compared with before treatment, the two groups after treatment hematocrit, erythrocyte aggregation index, whole blood viscosity, plasma viscosity decreased, serum CRP, TNF-α, ET-1, 24 h Pro, elevated serum NO, BUN, Scr levels decrease, increase the total protein level （P 〈0.05）. Compared with the control group, the observation group after treatment hematoerit, erythrocyte aggregation index, whole blood vis- cosity, plasma viscosity, low serum CRP, TNF-alpha, low ET-1, high serum NO, 24 h Pro, BUN, Scr level is low, the total protein levels were higher （ P 〈 0.05 ）. The control group had no difference with the observation of non-performing rate of 17.95 % group 23.08% non-performing rate comparison （P 〉 0.05 ）. Conclusion Huangqi Xianlingpi decoction combined with Huoxue Tongmai Tablet on blood coagulation in patients with nephrotic syndrome with high curative effect, and no increase in adverse reactions, and reduce CRP, TNF-α, improve endothelial and blood theology.

关 键 词：黄芪仙灵脾汤 活血通脉片 肾病综合征 高凝血症 C反应蛋白 肿瘤坏死因子Α 血液流变学 

分 类 号：R692[医药卫生—泌尿科学] R256.51[医药卫生—外科学]