通腑泄浊益气活血法治疗早期慢性肾脏病的临床疗效及其对免疫功能和血清TGF-β1、FN的影响  

Clinical efficacy of the method of dredging the fu organs,removing turbidity,replenishing qi and activating blood circulation in the treatment of early chronic kidney disease and its effect on immune function and serum TGF-β1,FN impact

作　　者：宋姝西 齐宁 杨宏伟[1] 刘香玉 SONG Shu-xi;QI Ning;YANG Hong-wei(Department of Nephrology,Tangshan People's Hospital,Tangshan Hebei 063000,China;Department of Integrated Traditional and Western Medicine,Affiliated Hospital of North China University of Science and Technology,Tangshan Hebei 063000,China)

机构地区：[1]唐山市人民医院肾内科,河北唐山063000 [2]华北理工大学附属医院中西医结合科,河北唐山063000 [3]华北理工大学附属医院中医科,河北唐山063000

出　　处：《临床和实验医学杂志》2023年第9期918-922,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2020218)。

摘　　要：目的观察通腑泄浊益气活血法治疗早期慢性肾脏病(CKD)的临床疗效及其对免疫功能和血清转化生长因子-β1(TGF-β1)、纤维连接蛋白(FN)的影响。方法前瞻性选取2019年7月至2021年6月唐山市人民医院肾内科收治的106例早期CKD患者为研究对象,采用随机数字表法将患者分为两组,每组53例。对照组给予西药对症治疗,观察组在西药基础上结合通腑泄浊益气活血法治疗。比较两组治疗前及治疗4周后TGF-β1、缺氧诱导因子-1α(HIF-1α)、FN、肾功能指标、Treg/Th17细胞免疫水平,统计两组治疗4周后疗效和安全性差异。结果与治疗前相比较,治疗4周后,两组肾小球滤过率(GFR)、Treg/Th17比例升高,TGF-β1、血肌酐、HIF-1α、FN、24 h尿蛋白定量、Th17比例降低,观察组Treg比例升高,且观察组GFR、Treg/Th17、Treg比例分别为(96.33±6.71)mL·min^(-1)·1.73m^(-2)、1.86±0.31、(4.31±0.83)%,均高于对照组[(86.96±7.14)mL·min^(-1)·1.73m^(-2)、1.41±0.28、(3.93±0.79)%],TGF-β1、血肌酐、HIF-1α、FN、24 h尿蛋白定量、Th17比例分别为(32.02±3.85)μg/L、(85.77±5.44)μmol/L、(16.85±3.14)ng/mL、(27.02±4.22)mg/L、(369.54±67.14)mg、(2.31±0.28)%,均低于对照组[(40.12±4.23)μg/L、(94.12±6.23)μmol/L、(21.23±3.63)ng/mL、(36.58±5.12)mg/L、(478.25±78.33)mg、(2.78±0.36)%],差异均有统计学意义(P<0.05)。治疗4周后观察组总有效率为88.68%,高于对照组(73.58%),差异有统计学意义(P<0.05)。观察组的不良反应发生率为11.32%,与对照组(7.55%)比较,差异无统计学意义(P>0.05)。结论通腑泄浊益气活血法治疗早期慢性肾脏病可改善肾功能和Treg/Th17细胞免疫,抑制肾间质纤维化,提高疗效。Objective To observe the clinical efficacy of the method of dredging the fu organs,removing turbidity,replenishing qi and activating blood circulation in the treatment of early chronic kidney disease(CKD)and its effect on immune function and serum transforming growth factor-β1(TGF-β1)and fibronectin(FN).Methods A total of 106 patients with early CKD admitted to the Department of Nephrology in Tangshan People's Hospital from July 2019 to June 2021 were prospectively selected as the subjects,and they were divided into two groups by random number table method,53 cases in each group.The control group was given symptomatic treatment with western medicine,while the observation group was treated with the method of dredging the fu organs,removing turbidity,supplementing qi and activating blood circulation on the basis of western medicine.The levels of TGF-β1,hypoxia inducible factor-1α(HIF-1α),FN,renal function indices,Treg/Th17 cell immune level before and 4 weeks after treatment of the two groups were compar and the statistical efficacy and safety differences 4 weeks after treatment were compared between the two groups.Results Compared with before treatment,the glomerular filtration rate(GFR),Treg/Th17 ratio in the two groups were increased,and TGF-β1,blood creatinine,HIF-1α,FN,24 h urine protein quantity,Th17 ratio were decreased,the Treg ratio in observation group was increased,and GFR,Treg/Th17,Treg ratio in the observation group were(96.33±6.71)mL·min^(-1)·1.73m^(-2),1.86±0.31,(4.31±0.83)%,respectively,which were higher than those in the control group[(86.96±7.14)mL·min^(-1)·1.73m^(-2),1.41±0.28,(3.93±0.79)%],TGF-β1,serum creatinine,HIF-1α,FN,24 h urine protein quantification,Th17 ratio were(32.02±3.85)μg/L,(85.77±5.44)μmol/L,(16.85±3.14)ng/mL,(27.02±4.22)mg/L,(369.54±67.14)mg,(2.31±0.28)%,respectively,which were lower than those in the control group[(40.12±4.23)μg/L,(94.12±6.23)μmol/L,(21.23±3.63)ng/mL,(36.58±5.12)mg/L,(478.25±78.33)mg,(2.78±0.36)%],the differences were statistic

关 键 词：通腑泄浊益气活血法 早期 Treg/Th17细胞免疫 慢性肾脏病 肾间质纤维化 

分 类 号：R692[医药卫生—泌尿科学]