摘要
目的 分析三白益肾方加减辅助治疗脾肾亏虚型慢性肾炎的效果及对24 h尿总蛋白定量、Th17/Treg细胞的影响。方法 选取2020年1月—2022年1月收治的100例脾肾亏虚型慢性肾炎为研究对象,按照随机数字表法分为观察组和对照组,每组50例。对照组采取厄贝沙坦片治疗,观察组采取三白益肾方加减辅助厄贝沙坦片治疗,连续治疗2个月。比较2组中医疗效及安全性,同时比较2组治疗前后中医证候积分、24 h尿总蛋白定量、肾功能指标[尿微量白蛋白/肌酐比值(ACR)、血尿素(BUN)、血肌酐(Scr)、胱抑素C(CysC)]、Th17/Treg细胞及其细胞因子[白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、白细胞介素-23(IL-23)、转化生长因子-β1(TGF-β1)]。结果 治疗2个月后,观察组治疗总有效率90.00%(45/50)明显高于对照组72.00%(36/50)(P<0.05)。治疗1、2个月后,观察组中医证候积分、24 h尿总蛋白定量、BUN、Scr、ACR、CysC、Th17/Treg细胞及血清IL-17、IL-23水平均低于对照组,血清TGF-β1、IL-10水平高于对照组(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 三白益肾方加减辅助治疗可有效降低脾肾亏虚型慢性肾炎患者24 h尿总蛋白定量,提高治疗效果,其可能机制与维持Th1/Treg细胞动态平衡有关。
Objective To analyze the effect of addition or reduction of Sanbai Yishen decoction in the adjuvant treatment of chronic nephritis of spleen-kidney deficiency type and its effect on 24-hour urinary total protein(24 h UTP)and Th17/Treg cells.Methods A total of 100 patients with chronic nephritis of spleen-kidney deficiency type treated from January 2020 to January 2022 were selected as the research subjects,and were divided into observation group(n=50)and control group(n=50)according to random number table method.The control group was treated with Irbesartan tablets,and the observation group was treated with addition or reduction of Sanbai Yishen formula and Irbesartan tablets for 2 consecutive months.The efficacy and safety of traditional Chinese medicine were compared between the two groups.In the meantime,the TCM syndrome scores,24 h UPT,renal function indicators[urinary microalbumin/creatinine ratio(ACR),blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(CysC)],Th17/Treg cells and their cytokines[interleukin-10(IL-10),interleukin-17(IL-17),interleukin-23(IL-23),transforming growth factor-β1(TGF-β1)]before and after treatment of the two groups were compared.Results At 2 months after treatment,the total effective rate of the observation group was 90.00%(45/50),which was significantly higher than that of the control group[72.00%(36/50)](P<0.05).At 1 and 2 months after treatment,TCM syndrome score,24 h UTP,BUN,Scr,ACR,CysC,Th17/Treg cells and serum levels of IL-17 and IL-23 in observation group were lower than those in control group,while serum levels of TGF-β1 and IL-10 were higher than those in 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 addition and reduction of Sanbai Yishen formula can effectively reduce the 24 h UTP in patients with chronic nephritis of spleen-kidney deficiency type and improve the therapeutic effect.The possible mechanism is related to the maintenance of dynamic balance of Th1/Treg cells.
作者
陈立祥
于贺美
王春宁
徐书芬
高福顺
CHEN Lixiang;YU Hemei;WANG Chunning;XU Shufen;GAO Fushun(Department of Nephrology,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000,China)
出处
《转化医学杂志》
2023年第6期374-379,共6页
Translational Medicine Journal
基金
河北省中医药管理局科研计划项目(2020538)。
作者简介
陈立祥,硕士研究生,中西医结合主治医师。主要从事肾病方向研究;通讯作者:徐书芬,E-mail:cc13653180903@126.com。
