血必净注射液联合参苓白术散加减治疗原发性肾病综合征合并急性肾衰竭疗效观察及机制探讨  

Observation on therapeutic effect and mechanism investigation of Xuebijing injection combined with Shenling Baizhu powder on primary nephrotic syndrome complicated with acute renal failure

作　　者：孙涛[1] 刘茜 尚丽英 韩兆灿 张敏 SUN Tao;LIU Qian;SHANG Liying(Department of Critical Care Medicine,The Second People's Hospital of Hengshui,Hengshui,Hebei 053000)

机构地区：[1]河北省衡水市第二人民医院重症医学科,河北衡水053000 [2]河北省衡水市第二人民医院康复医学科,河北衡水053000 [3]河北省衡水市第二人民医院肾内科,河北衡水053000

出　　处：《河北中医》2019年第2期214-219,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察血必净注射液联合参苓白术散加减对原发性肾病综合征合并急性肾衰竭的有效性和安全性,并探讨该治疗方案的作用机制。方法将68例原发性肾病综合征合并急性肾衰竭患者按照随机数字表法分为2组,每组各34例。2组均予对症治疗,对照组加血必净注射液治疗,治疗组在对照组治疗基础上加参苓白术散加减治疗。2组均连续治疗6周。比较2组治疗前后肾功能指标血肌酐、血尿素氮、尿β_2微球蛋白(β_2-MG)及24 h尿微量清蛋白、24 h尿蛋白定量水平变化,面色■白、水肿、形寒肢冷、胸水、腹水、大便溏薄症状评分变化,血液流变学变化,血清核转录因子-κB(NF-κB)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平变化。统计比较2组临床疗效及不良反应发生率。结果治疗后2组血肌酐、血尿素氮、β_2-MG及24 h尿微量清蛋白和24 h尿蛋白定量水平,面色■白、水肿、形寒肢冷、胸水、腹水、大便溏薄评分,全血黏度(高切、中切、低切)及血浆黏度,血清NF-κB、TNF-α和IL-6水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗组总有效率(88.24%)高于对照组(64.71%,P<0.05),不良反应发生率(35.29%)低于对照组(64.71%,P<0.05)。结论血必净注射液联合参苓白术散加减治疗原发性肾病综合征合并急性肾衰竭疗效确切,有"增效减毒"的优势,调节患者体内NF-κB、TNF-α和IL-6水平,减轻机体炎症状态,改善微循环,可能是其疗效途径。Objective To observe the efficacy and safety of Xuebijing injection combined with Shenling Baizhu powder in the treatment of primary nephrotic syndrome complicated with acute renal failure, and to explore the mechanism of the treatment. Methods 68 patients with primary nephrotic syndrome complicated with acute renal failure were divided into two groups according to random number table method, with 34 cases in each group. Both groups were given symptomatic treatment. The control group was treated by Xuebijing injection. The treatment group was treated by Shenling Baizhu powder on the basis of the control group. Both groups were treated for 6 weeks. The changes of renal function indexes, such as serum creatinine, blood urea nitrogen, urinary β 2-microglobulin (β 2-MG), 24-hour urinary microalbumin, 24-hour urinary protein in two groups were compared before and after treatment. The changes of pale complexion, edema, cold limbs, pleural effusion, ascites and loose stools score in two groups were compared before and after treatment. The changes of hemorheology, serum levels of nuclear factor-κB (NF-κB), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in two groups were compared before and after treatment. The clinical efficacy and incidence of adverse reactions were compared between the two groups. Results After treatment, the levels of serum creatinine, blood urea nitrogen,β 2-MG, 24-hour urinary microalbumin, 24-hour urinary albumin, pale complexion, edema, cold limbs, pleural effusion, ascites, loose stools score, whole blood viscosity (high, medium and low cut) and plasma viscosity, serum levels of NF-κB, TNF-α and IL-6 were lower in the two groups than those in the group before treatment ( P <0.05), and the treatment group was lower than the control group ( P <0.05). The total effective rate (88.24%) in the treatment group was higher than that in the control group (64.71%, P <0.05), and the incidence of adverse reactions (35.29%) was lower than that in the control group (64.71%, P <0.05). Conclus

关 键 词：肾病综合征 肾功能衰竭 中医疗法 参苓白术散 中成药 肿瘤坏死因子Α NF-κB 

分 类 号：R692.053.1[医药卫生—泌尿科学] R289.5[医药卫生—外科学]