摘要
目的探讨肾康宁胶囊联合吗替麦考酚酯治疗慢性肾小球肾炎(CGN)的效果及对溶酶体相关膜蛋白2(LAMP-2)、纤维蛋白溶解酶原激活物抑制剂-1(PAI-1)的影响。方法82例CGN患者,采用随机数字表法分为对照组和观察组,每组41例。对照组患者采用吗替麦考酚酯治疗,观察组患者在对照组基础上联合肾康宁胶囊治疗。比较两组疗效、中医证候改善时间、不良反应发生情况及治疗前后肾功能指标[血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)]、血清学指标[金属蛋白酶组织抑制剂-1(TIMP-1)、血管内皮生长因子(VEGF)、LAMP-2、PAI-1]水平。结果观察组总有效率为95.12%,高于对照组的80.49%,差异具有统计学意义(P<0.05)。治疗后,两组Scr、BUN、24 h Upro水平均低于本组治疗前,且观察组Scr(85.36±5.17)μmol/L、BUN(5.09±0.52)mmol/L、24 h Upro(0.98±0.12)g/24 h低于对照组的(115.78±9.23)μmol/L、(8.46±0.68)mmol/L、(1.61±0.24)g/24 h,差异具有统计学意义(P<0.05)。治疗后,两组TIMP-1、VEGF、LAMP-2、PAI-1水平均低于本组治疗前,且观察组TIMP-1(80.36±2.98)μg/L、VEGF(29.67±1.39)ng/L、LAMP-2(22.08±1.29)pg/ml、PAI-1(26.37±1.52)μmol/L低于对照组的(116.37±6.19)μg/L、(42.89±2.47)ng/L、(27.93±2.16)pg/ml、(37.49±3.46)μmol/L,差异具有统计学意义(P<0.05)。观察组夜尿频多、腰膝酸痛、疲倦乏力、头晕目眩改善时间分别为(7.23±1.28)、(9.68±1.46)、(5.17±0.87)、(8.96±1.07)d,均短于对照组的(10.96±1.79)、(12.17±1.96)、(9.25±1.24)、(11.98±1.72)d,差异具有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论肾康宁胶囊联合吗替麦考酚酯治疗CGN疗效确切,可抑制LAMP-2、PAI-1等细胞因子水平,调节血清TIMP-1、VEGF水平,改善患者肾功能,且不良反应较少,值得临床推广应用。
Objective To discuss the effect of Shenkangning Capsule combined with mycophenolate mofetil on chronic glomerulonephritis(CGN)and its influence on lysosome-associated membrane protein-2(LAMP-2)and plasminogen activator inhibitor-1(PAI-1).Methods A total of 82 cases of CGN patients were divided into control group and observation group according to the random numerical table,with 41 cases in each group.Patients in the control group were treated with mycophenolate mofetil,and patients in the observation group were treated with Shenkangning Capsule on the basis of control group.Both groups were compared in terms of efficacy,improvement time of traditional Chinese medicine syndromes,occurrence of adverse reactions,renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),24 h urinary protein quantity(24 h Upro),and serological indexes[tissue inhibitor of metalloproteinase-1(TIMP-1),vascular endothelial growth factor(VEGF),LAMP-2,PAI-1]before and after treatment.Results The total effective rate of 95.12%in the observation group was higher than that of 80.49%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of Scr,BUN and 24 h Upro in both groups were lower than those before treatment in this group;the observation group had Scr of(85.36±5.17)μmol/L,BUN of(5.09±0.52)mmol/L,and 24 h Upro of(0.98±0.12)g/24 h,which were lower than those of(115.78±9.23)μmol/L,(8.46±0.68)mmol/L,and(1.61±0.24)g/24 h in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of TIMP-1,VEGF,LAMP-2,and PAI-1 in both groups were lower than those before treatment in this group;the observation group had TIMP-1 of(80.36±2.98)μg/L,VEGF of(29.67±1.39)ng/L,LAMP-2 of(22.08±1.29)pg/ml,and PAI-1 of(26.37±1.52)μmol/L,which were lower than those of(116.37±6.19)μg/L,(42.89±2.47)ng/L,(27.93±2.16)pg/ml,and(37.49±3.46)μmol/L in the control group;the differences were statistically significant(P<0.05).In the observation group,the improvement time of frequent nocturnal urination,lumbus and knees soreness,fatigue and dizziness were(7.23±1.28),(9.68±1.46),(5.17±0.87)and(8.96±1.07)d,which were shorter than those of(10.96±1.79),(12.17±1.96),(9.25±1.24)and(11.98±1.72)d in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Shenkangning Capsule combined with mycophenolate mofetil has definite efficacy in the treatment of CGN,which can inhibit the levels of cytokines such as LAMP-2 and PAI-1,regulate the levels of serum TIMP-1 and VEGF,and improve patients'kidney function,with fewer adverse reactions,which is worthy of clinical promotion.
作者
李慧
LI Hui(Department of Nephrology(Blood Purification Department),Lingcheng District People's Hospital,Dezhou 253500,China)
出处
《中国实用医药》
2023年第14期21-25,共5页
China Practical Medicine
关键词
肾康宁胶囊
吗替麦考酚酯
慢性肾小球肾炎
效果
Chronic glomerulonephritis
Mycophenolate mofetil
Chronic glomerulonephritis
Effect
