不同剂量大黄附子细辛汤对慢性肾功能衰竭脾肾阳虚证患者肾功能、CRP、IL-6及TNF-a的影响
|
摘要
目的探讨不同剂量大黄附子细辛汤对慢性肾衰竭脾肾阳虚证患者炎症因子及临床疗效的观察。方法 120例确诊的慢性肾功能衰竭脾肾阳虚证患者随机分为治疗组和对照组各60例,两组在常规治疗基础之上,对照组给予小剂量大黄附子细辛汤,治疗组给予大剂量大黄附子细辛汤,观察两组患者治疗前后尿素氮(BUN)、血肌酐(Scr)、血清胱抑素C(CysC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-a(TNF-a)水平、药物不良反应及临床疗效。结果两组患者血清BUN、Scr、CysC、IL-6、TNF-a较治疗前均明显降低,治疗组下降幅度更为显著(P<0.05),治疗组治疗后中医证候积分及综合疗效均优于对照组(P<0.05),治疗后2组安全性比较无显著差异(P>0.05)。结论大剂量大黄附子细辛汤对慢性肾功能衰竭脾肾阳虚证患者中有助于改善肾功能,降低炎症因子水平,可能与降低血清炎性因子IL-6、TNF-a值,发挥抗炎及促进肾代谢作用有关。
Objective To explore the effects of different doses of Dahuang Fuzi Xixin Decoction on inflammatory factors and clinical efficacy in patients with chronic renal failure with syndrome of spleen and kidney Yang deficiency. Methods A total of 120 patients with chronic renal failure diagnosed with spleen and kidney Yang deficiency syndrome were randomly divided into a treatment group and a control group, with 60 cases in each group. The 2 groups were given conventional treatment. The control group was given a small dose of Dahuang Fuzi Xixin Decoction, and the treatment group was given large dose. The levels of urea nitrogen(BUN), serum creatinine(Scr), serum cystatin C(CysC), C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) were observed before and after treatment, and the adverse drug reactions and clinical effects were also observed before and after treatment. Results The serum levels of BUN, Scr, CysC, IL-6 and TNF-α in the 2 groups were significantly lower than those before treatment, and the decrease in the treatment group was more significant(P<0.05). The TCM syndromes scores and comprehensive efficacy in the treatment group were better than those in the control group after treatment in the treatment group(P<0.05), and there was no significant difference in the safety between the 2 groups(P>0.05). Conclusion Large-dose of Dahuang Fuzi Xixin Decoction can improve renal function and reduce inflammatory factors in patients with chronic renal failure and spleen and kidney Yang deficiency syndrome, which may be related with reducing serum inflammatory factors IL-6 and TNF-α, exerting antiinflammatory effects, and promoting kidney metabolism.
Objective To explore the effects of different doses of Dahuang Fuzi Xixin Decoction on inflammatory factors and clinical efficacy in patients with chronic renal failure with syndrome of spleen and kidney Yang deficiency. Methods A total of 120 patients with chronic renal failure diagnosed with spleen and kidney Yang deficiency syndrome were randomly divided into a treatment group and a control group, with 60 cases in each group. The 2 groups were given conventional treatment. The control group was given a small dose of Dahuang Fuzi Xixin Decoction, and the treatment group was given large dose. The levels of urea nitrogen(BUN), serum creatinine(Scr), serum cystatin C(CysC), C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) were observed before and after treatment, and the adverse drug reactions and clinical effects were also observed before and after treatment. Results The serum levels of BUN, Scr, CysC, IL-6 and TNF-α in the 2 groups were significantly lower than those before treatment, and the decrease in the treatment group was more significant(P<0.05). The TCM syndromes scores and comprehensive efficacy in the treatment group were better than those in the control group after treatment in the treatment group(P<0.05), and there was no significant difference in the safety between the 2 groups(P>0.05). Conclusion Large-dose of Dahuang Fuzi Xixin Decoction can improve renal function and reduce inflammatory factors in patients with chronic renal failure and spleen and kidney Yang deficiency syndrome, which may be related with reducing serum inflammatory factors IL-6 and TNF-α, exerting antiinflammatory effects, and promoting kidney metabolism.
引文
[1]许佩兰.大黄附子汤保留灌肠治疗慢性肾功能衰竭的观察及评估[J].中国现代药物用,2017,11(3):175-177.
[2]郑倩,李昌,郑霄,等.四诊合参方法在传统中药鉴定中的应用[J].中国药物经济学,2017,12(12):99-104.
[3]李燕敏,占永立,连凤梅,等.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭疗效对比观察[J].中医杂志,2011,52(24):2106-2108,2118.
[4]陈香美.临床诊疗指南:肾脏病学分册[M].北京:人民卫生出版社,2011:218-228.
[5]LEVEY A S,CORESH J.Chronic kidney disease[J].Lancet,2012,379:165-180.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:163-168.
[7]林婉.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭的疗效[J].中国妇幼健康研究,2017,28(4):445-446.
[8]刁海环.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭的对比分析[J].医学理论与实践,2017,30(12):1780-1781.
[9]邓跃毅,杨洪涛,孙伟,等.慢性肾脏病主要证型的中医辨证与治疗[J].中华肾病研究电子杂志,2013,2(5):9-12.
[10]孙曦,孙万森.温阳泄浊法治疗慢性肾衰竭概况[J].亚太传统医药,2016,12(21):70-71.
[11]吴鹏.健脾补肾降浊方治疗慢性肾衰(脾肾气虚型)的临床观察[J].光明中医,2017,32(16):2362-2364.
[12]尚莹莹,吴晓华,郭召平,等.浅析《金匮要略》“腹满”病之辨治[J].中医研究,2016,29(8):4-6.
[13]张洁媛.大黄化学成分与药理活性研究进展[J].现代养生,2018(22):93-94.
[14]丁香,赵万秋,蔡林.中药细辛的现代临床应用研究[J].临床合理用药杂志,2015,8(30):177-179.
[15]赵晓兰,崔秀珍.黄芪建中汤加减对慢性肾炎患者免疫应答的影响[J].世界中医药,2018,13(9):2229-2232.
[16]董凤彩.丹参成分及其药理作用[J].中国药物经济学,2015,10(3):99-100.
[17]杨洪涛.附子的毒副作用及在肾病中的合理应用[J].中华肾病研究电子杂志,2018,7(1):8-12.
[18]王兵.不同剂量大黄附子细辛汤对慢性肾衰竭患者中医证候积分及肾功能指标的影响[J].实用临床医药杂志,2012,16(17):34-36.
[19]姜元安.经方药物剂量在临床治疗中的意义[J].现代中医临床,2018,25(3):53-56.
[20]谷洪燕,吴秀强,李红萍.不同剂量雷米普利对早期糖尿病肾病患者血压及肾功能的影响[J].中国药房,2017,28(23):3268-3270.
[2]郑倩,李昌,郑霄,等.四诊合参方法在传统中药鉴定中的应用[J].中国药物经济学,2017,12(12):99-104.
[3]李燕敏,占永立,连凤梅,等.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭疗效对比观察[J].中医杂志,2011,52(24):2106-2108,2118.
[4]陈香美.临床诊疗指南:肾脏病学分册[M].北京:人民卫生出版社,2011:218-228.
[5]LEVEY A S,CORESH J.Chronic kidney disease[J].Lancet,2012,379:165-180.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:163-168.
[7]林婉.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭的疗效[J].中国妇幼健康研究,2017,28(4):445-446.
[8]刁海环.不同剂量大黄附子细辛汤治疗慢性肾功能衰竭的对比分析[J].医学理论与实践,2017,30(12):1780-1781.
[9]邓跃毅,杨洪涛,孙伟,等.慢性肾脏病主要证型的中医辨证与治疗[J].中华肾病研究电子杂志,2013,2(5):9-12.
[10]孙曦,孙万森.温阳泄浊法治疗慢性肾衰竭概况[J].亚太传统医药,2016,12(21):70-71.
[11]吴鹏.健脾补肾降浊方治疗慢性肾衰(脾肾气虚型)的临床观察[J].光明中医,2017,32(16):2362-2364.
[12]尚莹莹,吴晓华,郭召平,等.浅析《金匮要略》“腹满”病之辨治[J].中医研究,2016,29(8):4-6.
[13]张洁媛.大黄化学成分与药理活性研究进展[J].现代养生,2018(22):93-94.
[14]丁香,赵万秋,蔡林.中药细辛的现代临床应用研究[J].临床合理用药杂志,2015,8(30):177-179.
[15]赵晓兰,崔秀珍.黄芪建中汤加减对慢性肾炎患者免疫应答的影响[J].世界中医药,2018,13(9):2229-2232.
[16]董凤彩.丹参成分及其药理作用[J].中国药物经济学,2015,10(3):99-100.
[17]杨洪涛.附子的毒副作用及在肾病中的合理应用[J].中华肾病研究电子杂志,2018,7(1):8-12.
[18]王兵.不同剂量大黄附子细辛汤对慢性肾衰竭患者中医证候积分及肾功能指标的影响[J].实用临床医药杂志,2012,16(17):34-36.
[19]姜元安.经方药物剂量在临床治疗中的意义[J].现代中医临床,2018,25(3):53-56.
[20]谷洪燕,吴秀强,李红萍.不同剂量雷米普利对早期糖尿病肾病患者血压及肾功能的影响[J].中国药房,2017,28(23):3268-3270.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |