五苓散治疗肺肾气虚证慢性肾小球肾炎患者的临床疗效观察及对炎症因子的影响  

Observation on the Clinical Curative Effect of Wuling Powder in Treating Patients with Chronic Glomerulonephritis of Lung and Kidney Qi Deficiency and Its Effect on Inflammatory Factors

作　　者：杨静[1] 申世华[1] 刘静静[1] YANG Jing;SHEN Shihua;LIU Jingjing(The Third Affiliated Hospital of Anhui Medical University,Hefei First People's Hospital,Hefei 230000 Anhui,China)

机构地区：[1]安徽医科大学附属第三医院,合肥市第一人民医院,安徽合肥230000

出　　处：《中药新药与临床药理》2021年第9期1386-1390,共5页Traditional Chinese Drug Research and Clinical Pharmacology

基　　金：2020年度安徽省教育厅高校自然科学研究项目(KJ2020A0219);安徽省卫生和计划生育委员会“十三五”医疗卫生重点专科建设项目[皖卫科教[2017]30号]。

摘　　要：目的探讨五苓散治疗肺肾气虚证慢性肾小球肾炎患者的临床疗效及对超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的影响。方法选取合肥市第一人民医院肺肾气虚证慢性肾炎患者104例,随机分为对照组(52例)和观察组(52例)。所有患者皆给予纠正酸碱失衡、补充维生素、规范生活作息及控制饮食等常规治疗,对照组患者给予贝那普利片治疗,观察组在对照组的基础上给予五苓散治疗,疗程4周。观察2组患者治疗前后中医症状(浮肿、疲倦乏力、腰脊酸痛及少气懒言)评分、肾功能指标[24 h尿蛋白定量(UP)、血肌酐(Scr)、尿素氮(BUN)]、炎症因子(hs-CRP、TNF-α及IL-6)水平变化,并评价2组患者的临床疗效和安全性。结果观察组总有效率为96.15%(50/52)高于对照组的82.69%(43/52),差异有统计学意义(P<0.05);2组患者治疗后的浮肿、疲倦乏力、腰脊酸痛及少气懒言等中医症状评分较治疗前显著降低(P<0.05),且观察组各项中医症状评分明显低于对照组(P<0.05);治疗后,2组患者的24 h-UP、Scr及BUN水平较治疗前明显降低(P<0.05),且治疗后观察组24 h-UP、Scr及BUN水平均低于对照组(P<0.05);治疗后,2组患者的hs-CRP、TNF-α及IL-6水平较治疗前明显降低(P<0.05),且观察组炎症因子水平低于对照组(P<0.05)。治疗过程中,观察组患者咳嗽、恶心、头痛及疲乏等不良反应的发生率为5.77%(3/52),低于对照组的21.15%(11/52),差异有统计学意义(P<0.05)。结论五苓散联合贝那普利片治疗肺肾气虚证慢性肾小球肾炎患者疗效确切,能有效地减轻患者的临床症状和炎症反应,改善患者肾功能,安全性较高。Objective To explore the clinical efficacy of Wuling powder in the treatment of patients with chronic glomerulonephritis of lung and kidney qi deficiency,as well as to investigate the impact of hs-CRP,TNF-α,and IL-6.Methods 104 patients with chronic nephritis of lung and kidney qi deficiency in Hefei First People's Hospital were selected and randomly divided into control group(52 cases)and observation group(52 cases).All patients were given conventional treatments,such as correction of acid-base imbalance,supplementation with vitamin,standardization of daily life,and control of diet.The control group was given benazepril tablets,and the observation group was given Wuling powder on the basis of the control group.The course of treatment was 4 weeks.We observed the scores of TCM symptoms(edema,fatigue,soreness of the back and spine,and low-qi lazy speech),renal function indexes(24 h-UP,Scr,BUN),the levels of inflammatory factors(hs-CRP,TNF-αand IL-6)in 2 groups before and after treatment.The clinical efficacy and safety of the two groups of patients were evaluated.Results The total effective rate of the observation group was 96.15%(50/52),which was higher than 82.69%(43/52)of the control group,the difference was statistically significant(P<0.05).The scores of TCM symptoms(edema,fatigue,soreness of the back and spine,and low-qi lazy speech)of the two groups after treatment were significantly lower than those before treatment(P<0.05),and the scores of various TCM symptoms in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of 24 h-UP,Scr and BUN of 2 groups were significantly lower than those before treatment(P<0.05),and the levels of 24 h-UP,Scr and BUN in the observation group were lower than those in the control group(P<0.05).The levels of hs-CRP,TNF-αand IL-6 in the two groups after treatment were significantly lower than those before treatment(P<0.05),and the levels of inflammatory factors in the observation group were lower than those in the con

关 键 词：五苓散 慢性肾小球肾炎 临床疗效 安全性 超敏C反应蛋白 肿瘤坏死因子α 白细胞介素6 

分 类 号：R285.6[医药卫生—中药学]