摘要
目的:观察固肾健脾方联合醋酸泼尼松片对原发性肾病综合征(Primary nephrotic syndrome,PNS)患者的疗效及血小板活化指标、Toll样受体表达的影响。方法:选取我院于2020年2月~2022年2月收治的PNS患者126例,参照简单随机法进行均分组。对照组给予醋酸泼尼松片治疗,观察组给予固肾健脾方联合醋酸泼尼松片治疗。统计两组总有效率和安全性,记录两组治疗前和治疗8周后血小板活化指标[血小板活化因子(Platelet activating factor,PAF)、血小板活化因子水解酶(Platelet activating factor hydrolase,PAF-AH)]、肾功能指标(24h尿蛋白定量、血白蛋白)、血脂指标[总胆固醇(Total cholesterol,TC)、三酰甘油(Triacylglycerol,TG)]、Toll样受体[Toll样受体4(Toll like receptor 4,TLR4)、Toll样受体7(Toll like receptor 7,TLR7)]及中医证候积分的变化。结果:观察组经8周的治疗总有效率为92.06%(58例/63例),高于对照组的79.37%(50例/63例),有统计学意义(χ^(2)=4.148;P=0.0420.05)。两组PAF-AH、血白蛋白显著高于治疗前,PAF、24h尿蛋白定量、TC、TG、TLR4、TLR7显著低于治疗前(P<0.05),同时观察组PAF-AH、血白蛋白较对照组更高,而PAF、24h尿蛋白定量、TC、TG、TLR4、TLR7较对照组更低(P<0.05)。两组中医证候积分显著低于治疗前(P<0.05),同时观察组较对照组更低(P<0.05)。观察组用药期间不良反应率与对照组比较,无统计学意义(P>0.05)。结论:固肾健脾方联合醋酸泼尼松片治疗PNS可调节血小板活化因子、Toll样受体的表达,改善肾功能和血脂,提高疗效,且不增加不良反应。
Objective:To observe the efficacy of Gushen Jianpi Decoction combined with Prednisone Acetate Tablets on patients with primary nephrotic syndrome(Primary nephrotic syndrome,PNS)and the effect of platelet activation indexes and Toll-like receptor expression.Methods:A total of 126 patients with PNS were admitted to our hospital from February 2020 to February 2022 were selected and grouped according to the simple random method.The control group was treated with prednisone acetate tablets,while the observation group was given Gushen Jianpi recipe combined with prednisone acetate tablets.The total effective rate and safety of the two groups were calculated,and the platelet activation indexes[platelet activating factor(Platelet activating factor,PAF),platelet activating factor hydrolase(Platelet activating factor hydrolase,PAF-AH)],and renal function indexes(24h urine protein,blood albumin),blood lipid indexes[total cholesterol(Total cholesterol,TC),triacylglycerol(Triacylglycerol,TG)],Toll-like receptors[Toll-like receptor 4(Toll like receptor 4,TLR4),Toll-like receptor 7(Toll like receptor 7,TLR7)]and TCM syndromes scores before and after treatment for 8 weeks in two groups.Results:After 8 weeks of treatment,the total effective rate of the observation group was 92.06%(58 cases/63 cases),which was higher than that of the control group 79.37%(50 cases/63 cases),with statistical significance(χ^(2)=4.148;P=0.0420.05).PAF-AH and blood albumin in the two groups were significantly higher than those before treatment,while PAF,24h urine protein quantification,TC,TG,TLR4 and TLR7 were significantly lower than those before treatment(P<0.05).PAF-AH and serum albumin in the observation group were higher than those in the control group,while the PAF,24h urine protein quantification,TC,TG,TLR4 and TLR7 in the observation group were lower than the control group(P<0.05).The TCM syndrome scores of the two groups were significantly lower than those before treatment(P<0.05),while the observation group was lower than the control group(P<0.05).There was no statistical significance in the adverse reaction rate between the observation group and the control group during the treatment period(P>0.05).Conclusion:Gushen Jianpi Decoction combined with Prednisone Acetate Tablets in the treatment of PNS can regulate the expression of platelet activating factor and Toll-like receptor,improve renal function and blood lipids,and improve the curative effect without increasing adverse reactions.
作者
冯珍凤
陈利清
蔡浙毅
胡春平
刘曼曼
师金娟
陈见纺
孔雪倩
FENG Zhenfeng;CHEN Liqing;CAI Zheyi(Department of Internal Medicine Shanghai Jiading District Hospital of Traditional Chinese Medicine,Shanghai 201800,China)
出处
《四川中医》
2023年第4期107-111,共5页
Journal of Sichuan of Traditional Chinese Medicine
基金
上海市基层名老中医专家传承工作室建设项目(名称:蔡浙毅上海市基层名老中医专家传承工作室,编号:2020JCGZS-014)
作者简介
通讯作者:孔雪倩,硕士,主治医师,研究方向:内分泌疾病,E-mail:kongxueqian1982@126.com;冯珍凤,硕士,主治医师,研究方向:中医内分泌疾病,E-mail:jiyuhang06@163.com。
