肝肾宁治疗乙型肝炎病毒相关性肾炎脾肾亏虚型的临床疗效及对T淋巴细胞亚群的影响  

Effect of Ganshenning in the treatment of hepatitis B virus associated glomerulonephritis of spleen-kidney deficiency type and its effect on T lymphocyte subsets

作　　者：邢晓静[1] 杜立建[1] 李松[1] 向广生 赵雯红[1] XING Xiaojing;DU Lijian;LI Song(Department of Nephrology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050051)

机构地区：[1]河北省石家庄市中医院肾病科

出　　处：《河北中医》2019年第11期1621-1626,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2018年度中医药类科研计划项目(编号:2018221)

摘　　要：目的观察肝肾宁治疗乙型肝炎病毒相关性肾炎(HBV-GN)脾肾亏虚型的临床疗效及对T淋巴细胞亚群的影响。方法将65例HBV-GN脾肾亏虚型患者按照随机数字表法分为2组。对照组32例予血管紧张素转化酶抑制剂(ACEI)或血管紧张素受体阻滞剂(ARB)类药物降血压、降蛋白、利尿消肿、降血脂、抗凝、抗病毒保肝、激素等对症治疗;治疗组33例在对照组治疗基础上加用肝肾宁。2组均治疗6个月后统计临床疗效,观察2组治疗前后24 h尿蛋白定量(24 hUTP)、乙肝病毒脱氧核糖核酸(HBV-DNA)、肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(Alb)、总蛋白(TP)]及T淋巴细胞亚群(CD4^、CD8^+、CD4^+/CD8^+)变化情况。结果治疗组总有效率84.85%,对照组总有效率71.88%,治疗组临床疗效优于对照组(P<0.05)。治疗后2组24 hUTP均降低(P<0.05),且治疗组低于对照组(P<0.05);治疗后2组HBV-DNA均降低(P<0.05),且治疗组低于对照组(P<0.05);治疗后2组Alb、TP均升高(P<0.05),ALT、AST均降低(P<0.05),且治疗组Alb、TP均高于对照组(P<0.05),ALT、AST均低于对照组(P<0.05)。治疗后2组CD4^+均升高(P<0.05),CD8^+均降低(P<0.05),且治疗组CD4^+高于对照组(P<0.05),CD8^+低于对照组(P<0.05)。治疗组治疗后CD4^+/CD8^+升高(P<0.05),且高于对照组治疗后(P<0.05)。结论肝肾宁治疗HBV-GN脾肾亏虚型疗效确切,其机制可能与通过调节T淋巴细胞亚群,改善机体的免疫功能有关。Objective To observe the effect of Ganshenning in the treatment of hepatitis B virus associated glomerulonephritis(HBV-GN) of spleen-kidney deficiency type and its effect on T lymphocyte subsets. Methods 65 cases with HBV-GN of spleen-kidney deficiency type were randomly divided into two groups according to the random number table method. 32 cases in control group were treated by angiotensin converting enzyme inhibitors(ACEI) or angiotension receptor blocker(ARB) to reduce blood pressure, protein, diuresis, detumescence, blood lipid, anticoagulation, antiviral and liver protection, hormone, etc. 33 cases in treatment group were treated by Ganshenning on the basis of the control group. After 6 months of treatment, the clinical effect of the two groups were statistically analyzed. The changes of 24 h urinary protein(24 h UTP), hepatitis B virus desoxyribonucleic acid(HBV DNA), liver function [alanine amino transferase(ALT), aspartate amino transferase(AST), albumin(Alb), total protein(TP) ]and T lymphocyte subsets(CD4^+, CD8^+, CD4^+/CD8^+) were observed before and after treatment. Results The total effective rate was 84.85 % in treatment group and 71.88 % in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, 24 h UTP of the two groups was decreased(P<0.05), and the treatment group was lower than the control group(P<0.05). After treatment, HBV-DNA in the two groups was decreased(P<0.05), and the treatment group was lower than the control group(P<0.05). After treatment, Alb and TP were increased in the two groups(P<0.05), ALT and AST were decreased(P<0.05), and Alb and TP in the treatment group were higher than those in the control group(P<0.05), ALT and AST were lower than those in the control group(P<0.05). After treatment, CD4^+ was increased in two groups(P<0.05), CD8^+ was decreased(P<0.05), and CD4^+ in the treatment group was higher than that in the control group(P<0.05), CD8^+ was lower than that in the control group(P<0.05).

关 键 词：乙型肝炎病毒 肾炎 中药疗法 T淋巴细胞亚群 

分 类 号：R373.21[医药卫生—病原生物学] R692.3[医药卫生—基础医学]