益肾清利活血泄浊方治疗慢性肾脏病3~5期患者的临床疗效及对其血清细胞因子的影响  

Clinical Efficacy of Yishen Qingli Huoxue Xiezhuo Formula in Treating Patients with Chronic Kidney Disease Stages3-5 and Its Impact on Serum Cytokines

作　　者：倪杰[1] 赵静[1] 江燕[1] 孙伟[1] 李青[1] NI Jie;ZHAO Jing;JIANG Yan;SUN Wei;LI Qing(Nephrology Department,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210029)

机构地区：[1]南京中医药大学附属医院肾内科,江苏南京210029

出　　处：《世界中西医结合杂志》2024年第7期1458-1463,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医药科技发展计划重点项目(ZD202209);中国民族医药学会科研项目(2021Z1087-451201)。

摘　　要：目的观察益肾清利活血泄浊方治疗慢性肾脏病(Chronic kidney disease,CKD)3~5期患者的临床疗效及对其血清细胞因子的影响。方法选取2020年7月-2021年7月期间南京中医药大学附属医院(江苏省中医院)肾内科收治的89例CKD 3~5期患者,采用随机数字表法分为对照组45例和治疗组44例。对照组给予西医基础治疗,治疗组在对照组治疗基础上加用益肾清利活血泄浊方。治疗3个月后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医临床证候总积分、肾脏疾病相关指标[血清肌酐(Serum creatinine,Scr)、血尿素氮(Blood urea nitrogen,BUN)、肾小球滤过率(estimated glomerular filtration rate,eGFR)、血红蛋白(Hemoglobin,HGB)、白蛋白(Albumin,ALB)、24小时尿蛋白定量(24-Hour urinary total protein,UTP)]、细胞因子[白介素-1β(Interleukin-1β,IL-1β)、白介素-2(Interleukin-2,IL-2)、白介素-4(Interleukin-4,IL-4)、白介素-10(Interleukin-10,IL-10)、白介素-12P70(Interleukin-12P70,IL-12P70)、白介素-17(Interleukin-17,IL-17)、γ-干扰素(Interleukin-γ,INF-γ)及肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平。结果治疗后治疗组临床总有效率84.09%(37/44)明显高于对照组55.56%(25/45),差异有统计学意义(P<0.05)。治疗后两组患者中医临床证候总积分较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医临床证候总积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后对照组BUN、Scr、UTP水平较治疗前降低,Hb水平升高,差异有统计学意义(P<0.05);eGFR、ALB较治疗前升高,但差异无统计学意义(P>0.05)。治疗组BUN、Scr、UTP水平均较治疗前降低,eGFR、ALB及Hb水平均较治疗前升高,差异有统计学意义(P<0.05),且治疗组患者BUN、Scr、UTP水平均明显低于对照组,eGFR、ALB及Hb水平均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者促炎因子IL-2、IL-12P70、IL-17、IFN-γ及纤维化�Objective To observe the clinical efficacy of the Yishen Qingli Huoxue Xiezhuo formula in treating patients with chronic kidney disease(CKD)stages 3-5 and its impact on serum cytokines.Methods A total of 89 CKD stage 3~5 patients admitted to the Nephrology Department of Jiangsu Province Hospital of Chinese Medicine from July 2020 to July 2021 were selected.They were divided into a control group(45 cases)and a treatment group(44 cases)using the random number table method.The control group received basic Western medicine treatment,while the treatment group received the Yishen Qingli Huoxue Xiezhuo Formula in addition to the basic treatment.After three months of treatment,clinical efficacy,adverse reactions,the total score of traditional Chinese medicine(TCM)clinical symptoms,kidney-related indicators[serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),hemoglobin(Hb),albumin(ALB),24-hour urinary total protein(UTP)],and cytokine levels[interleukin-1β(IL-1β),interleukin-2(IL-2),interleukin-4(IL-4),interleukin-10(IL-10),interleukin-12P70(IL-12P70),interleukin-17(IL-17),interferon-γ(IFN-γ),and tumor necrosis factor-α(TNF-α)]were observed and compared before and after treatment.Results After treatment,the total clinical effective rate was significantly higher in the treatment group(84.09%,37/44)compared to the control group(55.56%,25/45),with a statistically significant difference(P<0.05).Both groups showed a significant decrease in the total score of TCM clinical symptoms after treatment,with a statistically significant difference(P<0.05);the treatment group showed a significantly lower score than the control group,with a statistically significant difference(P<0.05).The control group showed significant decreases in BUN,Scr,and UTP levels and a significant increase in Hb level compared to before treatment,with a statistically significant difference(P<0.05);while eGFR and ALB levels increased compared to before treatment,without a statistically significant difference(P>0.05).The

关 键 词：慢性肾脏病 益肾清利活血泄浊方 细胞因子 

分 类 号：R692[医药卫生—泌尿科学]