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引用本文:何明清1，张跃强2，胡彦辉3.益肾化瘀汤联合中药免疫抑制剂治疗慢性肾炎患者及对尿蛋白、肾纤维化的影响[J].世界中医药,2019,(06):.

益肾化瘀汤联合中药免疫抑制剂治疗慢性肾炎患者及对尿蛋白、肾纤维化的影响

Effects of Yishen Huayu Decoction Combined with Traditional Chinese Medicine Immunosuppressant on Chronic Nephritis and Its Effects on Urinary Protein and Renal Fibrosis

投稿时间：2018-05-23

DOI：10.3969/j.issn.1673-7202.2019.06.032

中文关键词: 益肾化瘀汤中药免疫抑制剂雷公藤多苷慢性肾炎尿蛋白肾纤维化临床疗效

English Keywords:Yishen Huayu Decoction Chinese medicine Immunosuppressive agents Tripterygium wilfordii glycosides Chronic glomerulonephritis Urinary protein Renal fibrosis Clinical efficacy

基金项目:河南省中医药科学研究专项（2015ZY02124）

作者	单位
何明清1，张跃强2，胡彦辉3	1 河南省周口市中医院糖尿病肾病科，周口，466000； 2 河南省周口市中医院肿瘤科,周口，466000； 3 郑州大学附属肿瘤医院/河南省肿瘤医院中西医结合科，郑州，450000

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中文摘要:

目的：探讨益肾化瘀汤联合中药免疫抑制剂治疗慢性肾炎患者的临床疗效及对尿蛋白、肾纤维化的影响。方法：选取2016年1月至2017年12月周口市中医院收治的慢性肾炎患者78例作为研究对象，采用随机数字表分组法分为对照组和观察组，每组39例。对照组采取低蛋白、低盐摄入、西药抗水肿、抗血小板、降脂、降压等对症治疗；观察组在对照组基础上给予益肾化瘀汤联合雷公藤多苷片治疗。比较2组治疗前后尿蛋白定量、血肌酐（Scr）、血尿素氮(BUN)、层粘连蛋白（LN）、Ⅲ型前胶原肽（PC-Ⅲ）、Ⅳ型胶原（Col-Ⅳ）、组织金属蛋白酶抑制剂-1(TIMP-1)、临床疗效及不良反应。结果：观察组总有效率（9487%）明显高于对照组（7949%），差异有统计学意义（P<005）；治疗前，2组尿蛋白定量、Scr、BUN、LN、PC-Ⅲ、Col-Ⅳ及TIMP-1水平比较，差异无统计学意义（P>005）；与治疗前比较，2组治疗后尿蛋白定量、Scr、BUN、LN、PC-Ⅲ、Col-Ⅳ及TIMP-1水平均显著降低，差异有统计学意义（P<005）；观察组治疗后尿蛋白定量、Scr、BUN、LN、PC-Ⅲ、Col-Ⅳ及TIMP-1水平均低于对照组，差异有统计学意义（P<005）；2组临床不良反应比较，差异无统计学意义（P>005）。结论：益肾化瘀汤联合中药免疫抑制剂可显著降低慢性肾炎患者尿蛋白量、改善肾功能、降低血清中LN、PC-Ⅲ、Col-Ⅳ及TIMP-1等肾纤维化指标，延缓肾纤维化的进程，临床疗效显著。

English Summary:

To investigate the clinical efficacy of Yishen Huayu Decoction combined with traditional Chinese medicine immunosuppressant in treating chronic nephritis and its effects on urinary protein and renal fibrosis. Methods:A total of 78 patients with chronic nephritis admitted to Zhoukou Hospital of Traditional Chinese Medicine from January 2016 to December 2017 were selected as the research subjects. The patients were divided into the control group and the observation group by random number table grouping method with 39 patients in each group. The control group received low protein, low salt intake, western medicine anti edema, anti platelet, lipid-lowering, and other symptomatic treatment. The observation group was treated with Yishen Huayu Decoction plus tripterygium glycosides tablets on the basis of the control group. Urine protein quantitation, serum creatinine (Scr), blood urea nitrogen (BUN), laminin (LN), procollagen peptide-III (PC-III), collagen-IV (Col-IV), tissue inhibitor of metalloproteinase-1 (TIMP-1), clinical efficacy and adverse reactions were compared between the two groups before and after treatment. Results:The total effective rate of the observation group (9487%) was significantly higher than that of the control group (7949%), and the difference was statistically significant (P<005). There was no significant difference in urine protein quantitation, Scr, BUN, LN, PC-III, Col-IV and TIMP-1 levels between the two groups before treatment (P>005). Urinary protein quantification, Scr, BUN, LN, PC-III, Col-IV and TIMP-1 levels in the two groups were significantly decreased after treatment (P<005). The levels of urine protein, Scr, BUN, LN, PC-III, Col-IV and TIMP-1 in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<005). There was no significant difference in clinical adverse reactions between the two groups (P>005). Conclusion:Yishen Huayu Decoction combined with traditional Chinese medicine immunosuppressant can significantly reduce the amount of urine protein in patients with chronic nephritis, improve renal function index, reduce the serum LN, PC-III, Col-IV and TIMP-1 renal fibrosis indexes, delay the process of renal fibrosis. The clinical effect is significant, and can be further applied.

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