健脾益肾汤加减治疗脾肾气虚兼血瘀型慢性肾小球肾炎的临床疗效及对患者肾功能、炎症因子、内皮功能和免疫球蛋白的影响  

Curative effect of modified Jianpi Yishen Decoction on chronic glomerulonephritis of spleen kidney qi deficiency and its influence on renal function,inflammatory factors,endothelial function and immunoglobulin

作　　者：徐书芬 陈立祥 于贺美 王春宁 高福顺 甄月娇 王志君 张军 马艳东 XU Shufen;CHEN Lixiang;YU Hemei;WANG Chunning;GAO Fushun;ZHEN Yuejiao;WANG Zhijun;ZHANG Jun;MA Yandong(Department of Endocrinology and Nephrology,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000;不详)

机构地区：[1]河北省衡水市中医医院内分泌肾病科,河北衡水053000 [2]河北省衡水市中医医院中医专家门诊,河北衡水053000

出　　处：《河北中医》2021年第7期1083-1086,1091,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药类科研计划课题(编号:2020538)。

摘　　要：目的观察健脾益肾汤加减治疗脾肾气虚兼血瘀型慢性肾小球肾炎(CGN)的临床疗效及对患者肾功能、炎症因子、内皮功能和免疫球蛋白的影响。方法将120例脾肾气虚型CGN患者按照随机数字表法分为2组,对照组60例予常规西医治疗,治疗组60例在对照组治疗基础上联合健脾益肾汤加减治疗。2组均连续治疗2个月。比较2组疗效;比较2组治疗前后肾功能指标血清胱抑素C(CysC)、肌酐(Cr)、尿素氮(BUN)、尿白蛋白排泄率(UAER),炎症因子粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞诱素-1(LKN-1)、肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8),内皮功能指标一氧化氮(NO)、内皮素(ET-1)、血管内皮生长因子(VEGF)及免疫球蛋白(Ig)M、IgG、IgA水平变化。结果治疗组总有效率96.67%(58/60),对照组总有效率83.33%(50/60),治疗组疗效优于对照组(P<0.05)。2组治疗后血清CysC、Cr、BUN、UAER水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后GM-CSF、TNF-α、IL-8、LKN-1水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后NO、VEGF水平均较本组治疗前升高(P<0.05),ET-1水平较本组治疗前降低(P<0.05),且治疗组治疗后NO、VEGF水平均高于对照组(P<0.05),ET-1水平低于对照组(P<0.05)。2组治疗后IgM、IgG、IgA水平均较本组治疗前升高(P<0.05),且治疗升高更明显(P<0.05)。结论健脾益肾汤加减治疗脾肾气虚兼血瘀型CGN,可改善患者肾功能,抑制炎性反应,提高患者血管内皮功能和免疫功能。Objective To observe the curative effect of modified Jianpi Yishen Decoction on chronic glomerulonephritis(CGN)of spleen kidney qi deficiency and its influence on renal function,inflammatory factors,endothelial function and immunoglobulin.Methods Totally 120 patients with CGN(spleen kidney qi deficiency)were randomly divided into 2 groups,60 cases in control group received conventional western medicine,and 60 cases in treatment group received modified Jianpi Yishen Decoction additionally.Treated for 2 months,aiming to compare renal function indexes including serum cystatin C(CysC),creatinine(Cr),blood usea nitrogen(BUN),urinary albumin excretion rate(UAER);inflammatory factors including granulocyte macrophage colony-stimulating factor(GM-CSF),leukotactin-1(LKN-1),tumor necrosis factor-α(TNF-α),interlukin-8(IL-8);endothelial function indices including nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF);immunoglobulin M(IgM),IgG,IgA.Results The total effective rates in treatment group were better than those in control group[96.67%(58/60)vs 83.33%(50/60),(P<0.05),respectively].After treatment,renal function index(CysC,Cr,BUN,UAER)in groups were decreased(P<0.05),which were decreased notably in treatment group when compared with control group(P<0.05);inflammatory factors(GM-CSF,TNF-α,IL-8,LKN-1)in groups were remarkably decreased(P<0.05),improvement of which in treatment group were significantly better(P<0.05);NO and VEGF in groups were increased(P<0.05),treatment group increased significantly(P<0.05);ET-1 were down-regulated(P<0.05),which were down-regulated notably in treatment group in comparison with control group(P<0.05);IgM,IgG and IgA in groups were increased(P<0.05),treatment group increased significantly(P<0.05).Conclusion For patients with CGN(spleen kidney qi deficiency),modified Jianpi Yishen Decoction can improve renal function,inhibit inflammatory response,and improve vascular endothelial function and immune function.

关 键 词：慢性病 肾小球肾炎 中药疗法 辨证 

分 类 号：R692.31[医药卫生—泌尿科学] R289.6[医药卫生—外科学]