腹膜化纤散对腹膜透析相关性腹膜纤维化及TGF-β_(1)/Smad_(2)信号通路的影响  

Study on the Effect of Peritoneal Chemical Fiber Powder on Peritoneal Dialysis-associated Peritoneal Fibrosis and TGF-β_(1)/Smad_(2) Signaling Pathway

作　　者：薛松[1] 吴国庆[1] 范伟[1] 李清萍[1] 罗学文 皮持衡[1] XUE Song;WU Guoqing;FAN Wei;LI Qingping;LUO Xuewen;PI Chiheng(Department of Nephrology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院肾病科,江西南昌330006

出　　处：《光明中医》2022年第2期234-238,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：江西省卫生健康委中医药科研计划课题(No.2018A083)。

摘　　要：目的观察中药腹膜化纤散对PD相关性腹膜纤维化的影响并探讨其可能的作用机制。方法选取90例正在行规律CAPD治疗且中医辨证为脾肾气(阳)虚、湿浊血瘀证的PD患者,随机分为治疗组与对照组各45例,2组均进行常规治疗,治疗组加用腹膜化纤散口服,共计观察60 d。观察2组中医临床疗效及中医证候积分,评价2组腹膜超滤功能、腹透充分性、残余肾功能保护情况,检测2组患者透析液中TGF-β_(1)、Smad_(2)、VEGF、α-SMA腹膜纤维化相关指标水平。结果经研究发现,治疗组中医临床证候疗效总有效率为75.56%,对照组中医临床证候疗效总有效率46.67%,治疗组疗效优于对照组(P <0.05);治疗组患者腹膜超滤功能nUF、Durea/Pureah、D_(4)/D_(0)指标显著优于对照组(P <0.01);治疗组腹透充分性评估显示KT/V、总Ccr水平显著优于对照组(P <0.01),治疗组对残肾GFR保护显著优于对照组(P <0.01);治疗组可显著降低腹膜透析液中VEGF、α-SMA蛋白表达(P <0.01),同时显著下调TGF-β_(1)/Smad_(2)信号通路蛋白水平(P <0.01)。结论腹膜化纤散对维持性CAPD患者腹膜功能具有一定的保护作用且能下调TGF-β_(1)/Smad_(2)信号通路表达。Objective To observe the effect of Chinese medicine peritoneal chemical fiber powder on peritoneal dialysis( PD)-associated associated peritoneal fibrosis and explore its possible mechanism. Methods 90 cases of PD patients undergoing regular CAPD treatment and with syndrome differentiation of spleen and kidney qi( yang) deficiency and dampness and turbidities and blood stasis were selected and randomly divided into the treatment group and the control group( with 45 cases in each). Both groups were treated with routine treatment,and the treatment group was additively treated with oral peritoneal chemical powder for 8 weeks. The clinical efficacy and traditional Chinese medicine( TCM) syndrome scores of the two groups were observed. Peritoneal ultrafiltration function,peritoneal permeability adequacy and residual renal function protection in the two groups were evaluated. The levels of peritoneal fibrosis related indexes of TGF-β_(1),Smad_(2),VEGF and α-SMA in dialysis fluid of the two groups were detected. Results The study found that the total effective rate of TCM clinical syndromes in the treatment group was 75. 56%,and the total effective rate of TCM clinical syndromes in the control group was 46. 67%,the treatment group was better than the control group( P < 0. 05). NuF,Durea/Pureah and D_(4)/D_(0)indexes of peritoneal ultrafiltration function in treatment group were significantly better than those in control group( P < 0. 01). The assessment of peritoneal permeability in the treatment group showed that the levels of KT/V and total CCR were significantly better than those in the control group( P < 0. 01),and the protection of GFR in the treatment group was significantly better than that in the control group( P < 0. 01). In the treatment group,the protein expression of VEGF andα-SMA in peritoneal dialysis fluid was significantly decreased( P < 0. 01),and the protein level of TGF-β_(1)/Smad_(2)signaling pathway was significantly down-regulated( P < 0. 01). Conclusion Peritoneal chemical fiber powder has a c

关 键 词：中医药疗法 腹膜透析 腹膜纤维化 信号通路 

分 类 号：R259[医药卫生—中西医结合]