活肾通络方联合依那普利对慢性肾脏病患者纤维化标志物、人附睾蛋白4水平的影响  

Effect of Huoshen Tongluo decoction and enalapril on renal function,fibrosis markers and HE4 levels in patients with chronic renal disease

作　　者：周林[1] 禹红[1] 刘毓玲[1] 肖桂香 ZHOU Lin;YU Hong;LIU Yuling;XIAO Guixiang(Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430050,China)

机构地区：[1]武汉市中医医院,湖北武汉430050 [2]华中科技大学同济医学院附属协和医院,湖北武汉430022

出　　处：《陕西中医》2023年第10期1400-1403,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：湖北省中医药管理局中医药科研项目(ZY2023F052);武汉市卫生健康委员会医学科研项目(WZ22C69,WZ19C37)。

摘　　要：目的:研究活肾通络方联合依那普利对2~4期慢性肾脏病(CKD)患者肾功能、纤维化标志物、人附睾蛋白4(HE4)水平的影响。方法:采用随机对照研究将78例2~4期CKD患者随机分为两组,各39例。对照组予依那普利,观察组予活肾通络方联合依那普利。两组治疗12周。疗程结束后比较两组疗效、主症和次症积分、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(C-Ⅳ)、层粘连蛋白(LN)、尿素(UR)、肌酐清除率(Ccr)、血肌酐(Scr)、β2-微球蛋白(β_(2)-MG)、HE4、高敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平、中医症候积分。结果:治疗后观察组总有效率92.31%高于对照组的74.36%(P<0.05);两组治疗前主症和次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Ccr、Scr、β_(2)-MG、HE4、hs-CRP、IL-6水平比较,差异无统计学意义(P>0.05);两组主症、次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Scr、β_(2)-MG、HE4、hs-CRP、IL-6水平下降,Ccr水平增加,观察组主症、次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Scr、β_(2)-MG、HE4水平低于对照组,Ccr水平高于对照组(P<0.05)。结论:活肾通络方联合依那普利可显著延缓2~4期CKD患者肾纤维化进程,保护肾功能,降低HE4水平。Objective:To study the effects of Huoshen Tongluo decoction combined with enalapril on renal function,fibrosis markers,and human epididymal protein 4(HE4)levels in patients with 2-4 chronic kidney disease(CKD).Methods:78 patients with stage 2-4 CKD were randomly divided into two groups,39 cases in each group.The control group was given enalapril,and the observation group was given Huoshen Tongluo decoction combined with enalapril.At the end of the treatment course,the efficacy,main and secondary symptom scores,hyaluronic acid(HA),procollagenⅢ(PC-Ⅲ),collagenⅣ(C-Ⅳ),laminin(LN),urea nitrogen(UR),creatinine clearance rate(Ccr),serum creatinine(Scr),β2-microglobulin(β_(2)-MG),HE4,high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)levels were compared.Results:After treatment the effective rate of the observation group 92.31%was significantly higher than the control group 74.36%(P<0.05).Before treatment,the main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Ccr,Scr,β_(2)-MG,HE4,hs-CRP and IL-6 had no significant difference between two groups(P>0.05);the main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Scr,β_(2)-MG,HE4,hs-CRP and IL-6 were decreased in two groups,and the level of Ccr was increased.The main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Scr,β_(2)-MG,HE4,hs-CRP and IL-6 were lower than those in the control group,and the levels of Ccr was higher than that in the control group(P<0.05).Conclusion:Huoshen Tongluo decoction combined with enalapril can significantly delay the progression of renal fibrosis,protect renal function,and reduce the level of HE4 in patients with 2-4 stage CKD.

关 键 词：慢性肾脏病 肾功能 活肾通络方 纤维化 人附睾蛋白4 

分 类 号：R692[医药卫生—泌尿科学]