清心莲子饮治疗过敏性紫癜性肾炎的疗效学及机制研究  

Study on Therapeutics and Mechanism of Qingxin Lianzi Decoction on Henoch-Schonlein Purpura Nephritis

作　　者：郑楠 王立范 ZHENG Nan;WANG Lifan(Department of Nephropathy,Heilongjiang Academy of Chinese Medicine,Harbin Heilongjiang 150036,China)

机构地区：[1]黑龙江省中医药科学院肾内科,黑龙江哈尔滨150036

出　　处：《中国卫生标准管理》2023年第3期152-158,共7页China Health Standard Management

基　　金：黑龙江省中医药管理局中医药科研课项目(ZHY2022-081);黑龙江省应用技术研究与开发计划项目(GY2019YF0230)。

摘　　要：目的观察经方清心莲子饮治疗过敏性紫癜性肾炎(henoch-schonlein purpura nephritis,HSPN)的临床疗效,同时初步探索其作用机制。方法选取2020年8月—2021年8月在黑龙江省中医药科学院肾内科住院的80例HSPN患者,将其随机分为治疗组(n=40)和对照组(n=40),对照组采用常规疗法,治疗组在其基础之上加服中药制剂清心莲子饮,8周后对于两组患者的临床疗效学进行评价,同时对治疗前后两组患者的中医证候学指标(紫斑,自汗,乏力,纳差,盗汗,口渴,烦躁,潮热及总证候积分);基础实验室指标:血肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、24 h尿总蛋白(24 h urine protein,24 h Upro)、尿红细胞计数(urine-red blood cell,U-RBC)、尿微量白蛋白尿肌酐比值(urinary albumin creatinine ratio,UACR),凝血功能指标:凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D),免疫学指标:肿瘤坏死因子-α(tumornecrosis factor-α,TNF-α)、白细胞介素-8(interleukin-8,IL-8)等方面进行比较和评价。结果治疗组在疗效学及改善各中医证候积分方面均优于对照组,差异有统计学意义(P<0.05),并能够改善肾脏Cr、BUN、24 h Upro、U-RBC、UACR等基础实验室指标,差异有统计学意义(P<0.05),在凝血机制及免疫学机制方面,治疗组可以显著上调PT、APTT水平,下调FIB、D-D、TNF-α、IL-8水平,发挥一定的干预调控作用,差异有统计学意义(P<0.05)。结论清心莲子饮对HSPN患者具有一定的治疗作用,并可以改善患者的中医证候和相关实验室指标,其机制可能与干预凝血及免疫学途径相关。Objective To observe the clinical effect of Qingxin Lianzi decoction on henoch schonlein purpura nephritis(HSPN),and to explore the mechanism of it.Methods A total of 80HSPN patients hospitalized in the department of nephropathy,Heilongjiang Academy of Chinese Medicine from August 2020 to August 2021 were randomly divided into treatment group(n=40)and control group(n=40),the control group was treated with conventional therapy,and in the treatment group,the traditional Chinese medicine of Qingxin Lianzi decoction was added,after 8 weeks,the clinical efficacy of the two groups was evaluated,at the same time,the indexes of the two groups before and after treatment were compared and evaluated,including traditional Chinese medicine syndrome indicators(purple spot,self perspiration,fatigue,poor appetite,night perspiration,thirst,irritability,hot tide and total syndrome score).Basic laboratory indicators:creatinine(Cr),blood urea nitrogen(BUN),24 h urine protein(24 h Upro),urine-red blood cell count(U-RBC),urinary albumin creatinine ratio(UACR),coagulation function indicators:prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D),immunological indicators:tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and other aspects were compared and evaluated.Results The treatment group was superior to the control group in terms of efficacy and improvement of traditional Chinese medicine syndrome scores,the differences were statistically significant(P<0.05),and could improve kidney Cr,BUN,24 h Upro,U-RBC,UACR and other basic laboratory indicators,the differences were statistically significant(P<0.05),in terms of coagulation mechanism and immunological mechanism,The treatment group could significantly up-regulate the levels of PT and APTT,and downregulate the levels of FIB,D-D,TNF-αand IL-8,playing a certain role in intervention and regulation,and the differences were statistically significant(P<0.05).Conclusion Qingxin Lianzi decoction has a certain therapeutic effect on HSPN patients,and

关 键 词：清心莲子饮 过敏性紫癜性肾炎 疗效 凝血 免疫学 机制 

分 类 号：R256[医药卫生—中医内科学]