固本泻浊法对肾病综合征患者肾小管损害标志物及免疫功能的影响  

Effect of Guben Xiefzhuo Method on Markers of Renal Tubular Damage and Immune Function of Patients with Nephrotic Syndrome

作　　者：康豪鹏 徐晓妍[2] KANG Haopeng;XU Xiaoyan(Henan Electric Power Hospital,Zhengzhou Henan China 450052;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南电力医院,河南郑州450052 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2024年第12期2667-2672,共6页Acta Chinese Medicine

基　　金：2022年全国名老中医药专家传承工作室建设项目{国中医药人教函〔2022〕76号}。

摘　　要：目的:观察从脾肾论治固本泻浊法治疗肾病综合征患者的应用价值。方法:102例肾病综合征患者随机平均分为对照组和观察组各51例。对照组给予泼尼松治疗,观察组在对照组基础上给予固本泻浊法治疗。比较两组临床疗效、中医证候积分、肾功能、肾小管损害标志物、血清相关因子、尿液水通道蛋白水平及免疫功能。结果:观察组有效率为94.12%(48/51),高于对照组的78.43%(40/51)(P<0.05)。两组治疗后面色浮肿、神疲乏力、面色晦暗、脘腹胀满、腰膝酸软、畏寒肢冷评分均显著降低,观察组低于对照组(P<0.05)。治疗后,两组血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)、24小时尿蛋白定量(24 hour urine total protein quantification,24hUTP)水平显著低于治疗前,观察组Scr为(123.82±40.32)mmol·L^(-1)、BUN为(3.18±1.24)μmol·L^(-1)、24hUTP为(1.84±0.73)g,显著低于同期对照组[Scr(170.36±61.28)mmol·L^(-1)、BUN(5.37±2.02)μmol·L^(-1)、24hUTP(3.17±0.92)g](P<0.05)。治疗后,两组中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)、肾损伤因子(kidney injury molecule-1,KIM-1)水平显著低于治疗前,观察组NGAL为(97.46±14.81)μg·L^(-1)、KIM-1为(1.21±0.34)μmol·L^(-1),显著低于同期对照组[NGAL(151.24±22.67)μg·L^(-1)和KIM-1(2.14±0.57)μmol·L^(-1)](P<0.05)。治疗后,两组血清视黄醇结合蛋白(retionl binding protein,RBP)、N-乙酰-β-D葡萄糖苷酶(N-acetyl-β-D-glucosidase,NAG)及尿液水通道蛋白2(aquaporin-2,AQP2)水平显著低于治疗前,观察组RBP为(1.63±0.28)mg·L^(-1)、NAG为(2.76±0.33)U·mmol^(-1)、AQP2为(50.23±8.31)nmol·L^(-1),显著低于同期对照组[RBP(2.42±0.45)mg·L^(-1)、NAG(4.27±0.54)U·mmol^(-1)、AQP2(79.87±9.64)nmol·L^(-1)](P<0.05)。两组治疗后CD3^(+)、CD4^(+)/CD8^(+)水平显著升高,观察组高于同期对照组(P<0.05)。结论:固本泻浊法可改善肾病综合征患者肾功能�Objective:To observe the application value of the method of solidifying and catharticizing from the theory of spleen and kidney in treating patients with nephrotic syndrome.Methods:102 patients with nephrotic syndrome were randomly divided into control group and observation group,with 51 cases in each group.The control group was treated with prednisone,and the observation group was treated with the method of consolidating the root and curing the turbidity on the basis of the treatment of the control group.The two groups were compared in terms of clinical efficacy,Chinese medicine syndrome points,renal function,markers of renal tubular damage,serum levels of related factors and urinary water channel protein,and immune function.Results:The effective rate of the observation group was 94.12%(48/51)higher than that of the control group,which was 78.43%(40/51)(P<0.05).The scores of puffiness,fatigue,dullness,distention and fullness of the stomach and abdomen,soreness and weakness of the waist and knees,and coldness and coldness of the limbs were significantly reduced in both groups after treatment,and the observation group was lower than the control group(P<0.05).After treatment,the levels of serum creatinine(Scr),blood urea nitrogen(blood urea nitrogen,BUN),and 24-hour urine total protein quantification(24hUTP)were significantly lower than those before treatment in both groups,and Scr in the observation group(P<0.05)was lower than that in the control group.(123.82±40.32)mmol·L^(-1),BUN was(3.18±1.24)μmol·L^(-1),and 24hUTP was(1.84±0.73)g,which were significantly lower than those in the control group during the same period[Scr(170.36±61.28)mmol·L^(-1),BUN(5.37±2.02)μmol·L^(-1),24hUTP(3.17±0.92)g](P<0.05).After treatment,the levels of neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)were significantly lower than those before treatment in both groups,with NGAL in the observation group at(97.46±14.81)μg·L^(-1)and KIM-1 were(1.21±0.34)μmol·L^(-1),which were significantly

关 键 词：肾病综合征 固本泻浊法 肾小管损害标志物 免疫功能 醋酸泼尼松片 

分 类 号：R277.592.6[医药卫生—中医学]