复方α酮酸+缬沙坦联合扶正祛湿饮治疗Ⅲ～Ⅳ期慢性肾脏病的研究
|
摘要
目的探讨复方α酮酸+缬沙坦联合扶正祛湿饮治疗Ⅲ～Ⅳ期慢性肾脏病疗效及对相关炎症因子、氧化应激指标水平的影响。方法将150例Ⅲ～Ⅳ期慢性肾脏病患者随机分为2组,对照组75例给予复方α酮酸+缬沙坦治疗,观察组75例在对照组基础上加用扶正祛湿饮辅助治疗。统计2组治疗6个月后临床疗效和不良反应发生率,观察2组治疗前及治疗6个月后24 h尿蛋白定量、血肌酐(SCr)、尿素氮(BUN)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、转化生长因子β1(TGF-β1)水平及健康调查简表(SF-36)评分变化情况。结果观察组治疗后24 h尿蛋白定量、SCr、BUN、IL-6、TNF-α及TGF-β1水平均显著低于治疗前及对照组(P均<0. 05),SOD、GSH-Px水平及SF-36评分均显著高于治疗前及对照组(P均<0. 05);观察组临床疗效显著优于对照组(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)。结论复方α酮酸+缬沙坦联合扶正祛湿饮治疗Ⅲ～Ⅳ期慢性肾脏病可有效控制相关症状体征,促进肾脏功能恢复,抑制机体炎症反应,调节SOD、GSH-Px及TGF-β1水平,且安全。
Objective It is to investigate the curative effect of compound α-ketoacid + valsartan combined with Fuzheng Qushi decoction in the treatment of stage Ⅲ-Ⅳ chronic kidney disease and its influence on the levels of related inflammatory factors and oxidative stress. Methods 150 patients with stage Ⅲ-Ⅳ chronic kidney disease were randomly divided into 2 groups. 75 patients in the control group were treated with compound α-ketoacid + valsartan. 75 patients in the observation group were given Fuzheng Qushi decoction for assisted therapy based on the control group. The clinical efficacy and adverse reaction rate were assessed after 6 months of treatment. The changes of the levels of 24 h urine protein quantitation,serum creatinine( SCr),urea nitrogen( BUN),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),superoxide dismutase( SOD),glutathione peroxidase( GSH-Px),transforming growth factor β1( TGF-β1) and the scores of Health Survey Summary( SF-36) were observed before and after 6 months of treatment. Results The levels of 24 h urine protein quantitation,SCr,BUN,IL-6,TNF-α and TGF-β1 in the observation group after treatment were significantly lower while the levels of SOD,GSH-Px and SF-36 scores were significantly higher than those before treatment and in the control group after treatment( P < 0. 05). The clinical efficacy of the observation group was significantly better than that of 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 Compound α-ketoacid + valsartan combined with Fuzheng Qushi decoction can effectively control the symptoms and signs,prevent renal function recovery,inhibit the body's inflammatory response and regulate SOD,GSH-Px and TGFβ1 levels with good safety in the treatment of stage Ⅲ-Ⅳ chronic kidney disease.
Objective It is to investigate the curative effect of compound α-ketoacid + valsartan combined with Fuzheng Qushi decoction in the treatment of stage Ⅲ-Ⅳ chronic kidney disease and its influence on the levels of related inflammatory factors and oxidative stress. Methods 150 patients with stage Ⅲ-Ⅳ chronic kidney disease were randomly divided into 2 groups. 75 patients in the control group were treated with compound α-ketoacid + valsartan. 75 patients in the observation group were given Fuzheng Qushi decoction for assisted therapy based on the control group. The clinical efficacy and adverse reaction rate were assessed after 6 months of treatment. The changes of the levels of 24 h urine protein quantitation,serum creatinine( SCr),urea nitrogen( BUN),tumor necrosis factor-α( TNF-α),interleukin-6( IL-6),superoxide dismutase( SOD),glutathione peroxidase( GSH-Px),transforming growth factor β1( TGF-β1) and the scores of Health Survey Summary( SF-36) were observed before and after 6 months of treatment. Results The levels of 24 h urine protein quantitation,SCr,BUN,IL-6,TNF-α and TGF-β1 in the observation group after treatment were significantly lower while the levels of SOD,GSH-Px and SF-36 scores were significantly higher than those before treatment and in the control group after treatment( P < 0. 05). The clinical efficacy of the observation group was significantly better than that of 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 Compound α-ketoacid + valsartan combined with Fuzheng Qushi decoction can effectively control the symptoms and signs,prevent renal function recovery,inhibit the body's inflammatory response and regulate SOD,GSH-Px and TGFβ1 levels with good safety in the treatment of stage Ⅲ-Ⅳ chronic kidney disease.
引文
[1]张晓光,汪年松,薛勤,等.慢性肾脏病进展危险因素的探讨[J].临床肾脏病杂志,2009,21(9):406-408
[2]Yano Y,Fujimoto S,Asahi K.Prevalence of chronic kidney disease in China:a cross-sectional survey[J].Lancet,2012,379(9818):815-822
[3]赵静,孙伟.影响慢性肾脏病2~3期的危险因素及治疗进展[J].中国中西医结合肾病杂志,2009,10(4):362-363
[4]戴昭秋,唐锦囊,王亿平.慢性肾衰竭的中医药治疗研究进展[J].甘肃中医学院学报,2012,29(6):80-82
[5]叶任高,沈清瑞.肾脏病诊断与治疗学[M].北京:人民卫生出版社,1994:201-207
[6]陈灏珠,林果为.实用内科学[M].北京:人民卫生出版社,2011:1976-1980
[7]中华中医药学会肾病分会.慢性肾衰竭的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2006,40(8):8-9
[8]Claes J,Ellis JA,Rettie F,et al.Survival in the australian chronic kidney disease population:potential effects of the CHOIR and CREATE studies[J].Nephrol Nurs J,2013,40(4):329-332
[9]王伟铭,陈永熙,陈楠.慢性肾脏病与肾脏纤维化和炎症[J].内科理论与实践,2007,2(6):417-419
[10]沈文清,邢艳芳,黄丽,等.微炎症及氧化应激对慢性肾脏病患者肾功能的影响[J].中国临床医学,2012,19(5):500-501
[11]王荣珍,梁昭红,刘天喜.慢性肾脏病患者肾功能与微炎症及氧化应激的相关性[J].兰州大学学报:医学版,2011,37(1):62-66
[12]任苗苗,杜玄一.转化生长因子β在慢性肾脏病中的作用[J].临床荟萃,2012,27(24):2184-2188
[13]邢国兰,胡晓舟,刘章锁,等.慢性肾脏病治疗的临床决策[J].医学与哲学,2007,28(18):42-43
[14]海慧,马居里,崔娜,等.扶正泄浊保肾汤对慢性肾功能衰竭患者HA,LN的影响[J].中国实验方剂学杂志,2011,17(16):262-264
[15]张昕贤,陈刚,何立群.何立群教授从瘀论治慢性肾脏病经验撷菁[J].中医药信息,2011,28(5):72-73
[16]田婷.基于药理学和代谢组学方法研究茯苓和茯苓皮的利尿活性及其对慢性肾脏病防治作用[D].西安:西北大学,2016
[17]彭华胜,刘文哲,胡正海.太子参的生物学与化学成分的研究进展[J].中草药,2008,39(3):470-473
[18]孙健,腊岩.丹参及其组分的药理作用以及在肾脏病的最新应用进展[J].中国中西医结合肾病杂志,2010,11(1):89-91
[2]Yano Y,Fujimoto S,Asahi K.Prevalence of chronic kidney disease in China:a cross-sectional survey[J].Lancet,2012,379(9818):815-822
[3]赵静,孙伟.影响慢性肾脏病2~3期的危险因素及治疗进展[J].中国中西医结合肾病杂志,2009,10(4):362-363
[4]戴昭秋,唐锦囊,王亿平.慢性肾衰竭的中医药治疗研究进展[J].甘肃中医学院学报,2012,29(6):80-82
[5]叶任高,沈清瑞.肾脏病诊断与治疗学[M].北京:人民卫生出版社,1994:201-207
[6]陈灏珠,林果为.实用内科学[M].北京:人民卫生出版社,2011:1976-1980
[7]中华中医药学会肾病分会.慢性肾衰竭的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2006,40(8):8-9
[8]Claes J,Ellis JA,Rettie F,et al.Survival in the australian chronic kidney disease population:potential effects of the CHOIR and CREATE studies[J].Nephrol Nurs J,2013,40(4):329-332
[9]王伟铭,陈永熙,陈楠.慢性肾脏病与肾脏纤维化和炎症[J].内科理论与实践,2007,2(6):417-419
[10]沈文清,邢艳芳,黄丽,等.微炎症及氧化应激对慢性肾脏病患者肾功能的影响[J].中国临床医学,2012,19(5):500-501
[11]王荣珍,梁昭红,刘天喜.慢性肾脏病患者肾功能与微炎症及氧化应激的相关性[J].兰州大学学报:医学版,2011,37(1):62-66
[12]任苗苗,杜玄一.转化生长因子β在慢性肾脏病中的作用[J].临床荟萃,2012,27(24):2184-2188
[13]邢国兰,胡晓舟,刘章锁,等.慢性肾脏病治疗的临床决策[J].医学与哲学,2007,28(18):42-43
[14]海慧,马居里,崔娜,等.扶正泄浊保肾汤对慢性肾功能衰竭患者HA,LN的影响[J].中国实验方剂学杂志,2011,17(16):262-264
[15]张昕贤,陈刚,何立群.何立群教授从瘀论治慢性肾脏病经验撷菁[J].中医药信息,2011,28(5):72-73
[16]田婷.基于药理学和代谢组学方法研究茯苓和茯苓皮的利尿活性及其对慢性肾脏病防治作用[D].西安:西北大学,2016
[17]彭华胜,刘文哲,胡正海.太子参的生物学与化学成分的研究进展[J].中草药,2008,39(3):470-473
[18]孙健,腊岩.丹参及其组分的药理作用以及在肾脏病的最新应用进展[J].中国中西医结合肾病杂志,2010,11(1):89-91