摘要
目的观察凉血散瘀汤联合替米沙坦治疗肾虚血瘀型IgA肾病患者的疗效及对肾脏纤维化相关细胞因子和纤维化指标的影响。方法将64例肾虚血瘀型IgA肾病患者按抽签法分为2组,对照组32例在基础治疗同时给予替米沙坦片口服,实验组32例在对照组治疗基础上给予凉血散瘀汤口服,2组均以2周为1个疗程,连续治疗4个疗程。观察2组治疗前后24 h尿蛋白定量、尿红细胞计数、内生肌酐清除率(Ccr)和血清细胞因子指标[转化生长因子-β1(TGF-β1)、单核细胞趋化蛋白-1(MCP-1)、血管内皮生长因子(VEGF)、巨噬细胞移动抑制因子(MIF)]、肾脏纤维化指标[Ⅳ型胶原(C-Ⅳ)、层黏连蛋白(LN)、基质金属蛋白酶组织抑制剂-1(TIMP-1)]变化情况,记录2组不良反应发生情况。结果治疗后,2组24 h尿蛋白定量、尿红细胞计数均明显降低(P均<0. 05),且实验组明显低于对照组(P均<0. 05); 2组Ccr均无明显变化(P均> 0. 05)。治疗后,2组血清TGF-β1、MCP-1、MIF、C-Ⅳ、LN、TIMP-1水平均明显降低(P均<0. 05),且实验组各指标水平均明显低于对照组(P均<0. 05); 2组血清VEGF水平均明显升高(P均<0. 05),且实验组明显高于对照组(P <0. 05)。2组不良反应发生率比较差异无统计学意义(P>0. 05)。结论凉血散瘀汤联合替米沙坦治疗肾虚血瘀型IgA肾病可有效降低患者24 h尿蛋白定量和尿红细胞计数,可延缓肾脏纤维化,且临床安全性高。
Objective It is to observe the curative effect of Liangxueshuyu decoction combined with telmisartan on IgA nephropathy of type of renal deficiency and blood stasis and its effect on cytokines and fibrosis indexes of renal fibrosis.Methods 64 patients with IgA nephropathy of type of renal deficiency and blood stasis were divided into experimental group(n=32)and control group(n=32).The control group was treated with basic therapy plus telmisartan tablets.The experimental group was treated with Liangxue Sanyu decoction the basis of control group.2 weeks as one treatment course,both groups were treated for 2 courses.The changes of levels of 24 h urinary protein(24h U-pro),erythrocyte(RBC),endogenous creatinine clearance(Ccr),serological cytokines[transforming growth factor-β1(TGF-β1),monocyte chemotaxis(MCP-1),vascular endothelial growth factor(VEGF),macrophage migration inhibitory factor(MIF)],renal fibrosis indexes[collagenⅣ(Col-Ⅳ),laminin(LN),matrix metal(TIMP-1)]before and after treatment were observed,and the adverse reactions were recorded in the two groups.Results After treatment,the 24 h U-pro and RBC of the two groups were significantly lower than those before treatment(P<0.05),and the decrease was more significant in the experiment group,there was no significant difference in Ccr between the two groups(P>0.05).After treatment,the levels of TGF-β1,MCP-1,MIF,Col-Ⅳ,LN and TIMP-1 in the two groups were significantly lower(P<0.05),while the level of VEGF was significantly higher than those before treatment(P<0.05),and the improvements of these indicators in the experiment group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of Liangxueshuyu decoction combined with telmisartan can effectively reduce 24h U-pro and RBC,delay the development of renal fibrosis with high safety in the treatment of IgA nephropathy with renal deficiency and blood stasis.
作者
郑静
刘旭阳
ZHENG Jing;LIU Xuyang(The People’s Hospital of Kaizhou District,Chongqing 405400,China)
出处
《现代中西医结合杂志》
CAS
2018年第32期3546-3549,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
重庆市科技计划项目(20161011)
关键词
凉血散瘀汤
替米沙坦
肾虚血瘀型IgA肾病
细胞因子
肾脏纤维化
Liangxue Sanyu decoction
telmisartan
type of renal deficiency and blood stasis
IgA nephropathy
cytokines
renal fibrosis
