益肾活血解毒方联合免疫抑制剂治疗慢性移植肾损伤临床研究  

Clinical Study of Formula for Replenishing Kidney and Activating Blood and Removing Toxin Combined with Immunosuppressant in the Treatment of Chronic Allograft Injury

作　　者：王锁刚[1] 娄丽霞[2] 张楠[3] 翟琼瑶 王光策[1] WANG Suo-gang;LOU Li-xia;ZHANG Nan;ZHAI Qiong-yao;WANG Guang-ce(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450001;Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450008;People′s Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,45000)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450001 [2]河南中医药大学第三附属医院,河南郑州450008 [3]河南中医药大学人民医院,河南郑州450000

出　　处：《河南中医》2021年第6期884-888,共5页Henan Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(2018ZY2077)。

摘　　要：目的:观察益肾活血解毒方联合免疫抑制剂治疗慢性移植肾损伤(chronic allograft injury,CAI)的临床疗效。方法:将90例CAI患者按照随机数字表法分为观察组和对照组,每组各45例。两组患者均应用常规免疫抑制方案治疗,观察组在对照组治疗的基础上加用益肾活血解毒方。比较两组患者的临床疗效,检测两组患者治疗前后血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、尿酸(uric acid,UA)、胱抑素C(cystatin C,Cys C)等肾功能指标,并计算肌酐清除率(creatinine clearance rate,Ccr);采用三色流式细胞术检测外周血T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)等细胞计数。结果:对照组有效率为46.7%,观察组有效率为77.8%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后BUN、Scr、UA、Cys C、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)低于本组治疗前,观察组治疗后低于对照组同期治疗后,两组患者Ccr、CD8^(+)高于本组治疗前,观察组治疗后高于对照组同期治疗后,差异均有统计学意义(P<0.05)。结论:益肾活血解毒方能够提高免疫抑制剂治疗效果,改善移植肾功能,延缓CAI的临床进展,且可通过提高T淋巴细胞亚群的水平而参与免疫调节。Objective:To observe the clinical curative effect of Formula for Replenishing Kidney and Activating Blood and Removing Toxin combined with immunosuppressant on chronic allograft injury(CAI).Methods:A total of 90 patients with CAI were randomly divided into the observation group and the control group,with 45 cases in each group.Both groups were treated with routine immunosuppressive regimen,and the observation group was additionally treated with Formula for Replenishing Kidney and Activating Blood and Removing Toxin on the basis of the control group.The clinical effects of the two groups were compared.Blood urea nitrogen(BUN),serum creatinine(Scr),uric acid(UA)and cystatin C(Cys C)and other renal function indexes were measured before and after treatment.Creatinine clearance rate(Ccr)was calculated.T lymphocyte subsets CD3^(+),CD4^(+),CD8^(+)in peripheral blood were detected by three color flow cytometry.Results:The effective rate of the control group was 46.7%,while that of the observation group was 77.8%,and the difference was statistically significant(P<0.05).After treatment,BUN,Scr,UA,Cys C,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the two groups were lower than those of the same group before treatment,and the above indexes of the observation group were lower than those of the control group.However,Ccr and CD8^(+)of the two groups were higher than those of the same group before treatment,and the above indexes of the observation group were higher than those of the control group,and all the differences were statistically significant(P<0.05).Conclusion:Formula for Replenishing Kidney and Activating Blood and Removing Toxin can improve the therapeutic effect of immunosuppressant,improve the function of transplanted kidney,delay the clinical progress of CAI,and participate in immune regulation by increasing the level of T lymphocyte subsets.

关 键 词：慢性移植肾损伤 益肾活血解毒方 免疫抑制剂 中西医结合疗法 

分 类 号：R277.592[医药卫生—中医学]