黄芪益肾颗粒联合腹膜透析对慢性肾衰竭肾功能及血清miR-30a、Hcy、CysC表达影响  

Effect of Huangqi Yishen Granules( 黄芪益肾颗粒) Combined with Peritoneal Dialysis on Renal Function and Expressions of Serum miR - 30a,Hcy and CysC in Patients with Chronic Renal Failure

作　　者：王波 肖健[1] 刘正萌 杨小华[1] 何绍沿 WANG Bo;XIAO Jian;LIU Zhengmeng;YANG Xiaohua;HE Shaoyan(Guangyuan Central Hospital,Guangyuan 628000,Sichuan,China)

机构地区：[1]广元市中心医院,四川广元628000

出　　处：《中华中医药学刊》2022年第6期161-165,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：中华医学会临床医学科研专项(192605935953)。

摘　　要：目的探究黄芪益肾颗粒联合腹膜透析对慢性肾衰竭(CRF)患者肾功能及血清微RNA-30a(miR-30a)、同型半胱氨酸(Hcy)、胱抑素C(Cys C)表达的影响。方法选取2017年10月—2019年12月医院112例CRF患者进行前瞻性随机对照研究,以计算机生成的随机数字表将患者分为研究组(56例)、对照组(56例)。常规治疗基础上,对照组予以腹膜透析,研究组予以黄芪益肾颗粒联合腹膜透析,均连续治疗2个月。比较两组疗效、治疗前、治疗2个月后肾功能指标[血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)]、症状积分、血清炎症因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、T淋巴细胞亚群指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、miR-30a、Hcy、CysC水平。结果研究组治疗2个月后总有效率(92.86%,52/56)高于对照组(76.79%,43/56)(P<0.05);研究组治疗2个月后血清Scr、BUN及24 h Upro水平均低于对照组(P<0.05);研究组治疗2个月后倦怠乏力、腰膝酸软、夜尿、多尿、水肿、贫血积分均低于对照组(P<0.05);研究组治疗2个月后血清TNF-α、IL-6、CRP水平均低于对照组(P<0.05);研究组治疗2个月后血清CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平高于对照组,CD_(8)^(+)水平低于对照组(P<0.05);研究组治疗2个月后血清miR-30a、Hcy、CysC水平均低于对照组(P<0.05)。结论CRF患者腹膜透析治疗中联合应用黄芪益肾颗粒,能进一步下调血清miR-30a、Hcy、CysC表达,增强机体免疫功能,促进患者肾功能改善,减轻炎症反应及临床症状,显著提高疗效。Objective To explore the effect of Huangqi Yishen Granules(黄芪益肾颗粒)combined with peritoneal dialysis on renal function and expression of microRNA-30a(miR-30a),homocysteine(Hcy)and cystatin C(Cys C)in patients with chro-nic renal failure(CRF).Methods A prospective randomized controlled study was performed on 112 patients with CRF in the hos-pital from October 2017 to December 2019.The patients were divided into a study group(56 cases)and a control group(56 ca-ses)by a computer-generated random number table.On the basis of conventional treatment,the control group was given perito-neal dialysis and the study group was given Huangqi Yishen Granules combined with peritoneal dialysis,both of which were trea-ted continuously for 2 months.The efficacy,the levels of renal function indexes[blood creatinine(Scr),urea nitrogen(BUN),24-hour urine proteinquantitative(24 h Upro)],the symptom score,the levels of serum inflammatory factor indexes[tumor nec-rosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)],the levels of T lymphocyte subset index(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)),the expressions of miR-30a,Hcy and CysC before and after 2 months of treatment were compared between the two groups.Results The total effective rate(92.86%,52/56)of the study group after 2 months of treatment was higher than that of the control group(76.79%,43/56)(P<0.05).The levels of serum Scr,BUN and 24 h Upro in the study group were lower than those in the control group after 2 months of treatment(P<0.05).The scores of burnout and fatigue,sore waist and knees,nocturia,polyuria,edema and anemia in the study group were lower than those in the control group after 2 months of treat-ment(P<0.05).The levels of serum TNF-α,IL-6 and CRP in the study group were lower than those in the control group af-months of treatment(P<0.05).The levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in serum in the study group were higher than those of the control group after 2 months of treatment,and the CD_(8)^(+)level was lower than that of t

关 键 词：慢性肾衰竭 黄芪益肾颗粒 腹膜透析 肾功能 微RNA-30a 同型半胱氨酸 胱抑素C 

分 类 号：R269.925[医药卫生—中西医结合]