世界中医药

目的：观察黄葵胶囊治疗原发性肾病综合征的临床疗效，及对患者微炎状态和血管生成素样蛋白3的表达影响。方法：选取2016年3月至2018年3月重庆市第七人民医院收治的原发性肾病综合征患者120例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组60例，对照组患者予低盐低脂低蛋白饮食，同时给予抗凝、抗PLT聚集、降脂、利尿及激素治疗。观察组在对照组的用药基础上，给予黄葵胶囊5粒/次，早中晚饭后各1次。对照组和观察组均治疗2个月作为1个疗程。原发肾病综合生化指标分别检测24 h尿蛋白定量，血清白蛋白（Alb）含量，和血肌酐（Scr）含量。微炎状态指标检测患者血清内的IL-6、IL-8和TNF-α含量等；血管生成素样蛋白3（ANGPTL3）：于治疗前和治疗后2组患者常规肾活检，将所取的肾组织进行常规石蜡包埋固定，由病理科专人负责进行常规切片和ANGPTL3的免疫组化染色，取10个视野中得到免疫组化指数取平均值后进行统计学分析。结果：1）观察组总有效率为83.33%，而对照组总有效率为65.00%，经卡方检验分析，2组总有效率差异有统计学意义（P<0.05），黄葵胶囊对原发性肾病综合征具有一定的临床疗效。2）治疗后2组3个指标中，24 h尿蛋白和Scr均明显减少（P<0.05），而Alb显著升高（P<0.05），其中观察组黄葵胶囊对24 h尿蛋白和Scr的下降程度及Alb的提高程度均优于对照组（P<0.05）。3）治疗后2组IL-6、IL-8和TNF-α均明显下调（P<0.05），观察组黄葵胶囊对IL-6、IL-8和TNF-α的下调程度优于对照组（P<0.05）。4）治疗后2组ANGPTL3免疫组化指数均明显降低（P<0.05），观察组黄葵胶囊对ANGPTL3免疫组化指数的降低程度优于对照组（P<0.05），且ANGPTL3与IL-6、IL-8及TNF-α均存在正相关性。结论：黄葵胶囊治疗原发性肾病综合征抑制患者微炎状态，降低血管生成素样蛋白3，具有更好的临床治疗效果。

English Summary:

To observe the clinical efficacy of Huangkui Capsules in treating primary nephrotic syndrome and its effects on the microinflammatory state and the expression of angiopoietin like protein 3.Methods:A total of 120 cases of primary nephrotic syndrome in Chongqing Seventh People's Hospital from March 2016 to March 2018 were selected and randomly divided into an observation group and a control group according to random number table，with 60 cases in each group.The control group was given low salt low fat and low protein diet，and also given anticoagulant，anti PLT aggregation，lipid lowering，diuresis，and hormones treatment.On the basis of the control group，the observation group was given Huangkui Capsules，5 capsules per time，each in the morning，noon，and evening.Both groups were treated for 2 months as one treatment course.The levels of 24 hours urine protein，serum albumin(Alb)and serum creatinine(Scr)were detected for comprehensive biochemical indicators of primary nephrotic syndrome.The level of IL-6，IL-8 and TNF-α in the serum of patients was detected for the microinflammatory condition.For angiopoietin like protein 3(ANGPTL3)，routine renal biopsy was performed in the 2 groups of patients before and after treatment.Routine paraffin embedded fixation was carried out in the renal tissue.The routine section and immunohistochemical staining of ANGPTL3 were carried out by the special subjects of the pathology department.The average value of immunohistochemical index was obtained from 10 views，and then the data were analyzed statistically.Results:1)The total effective rate of the observation group was 83.33%，while the total effective rate of the control group was 65.00%.After the chi square test analysis，the total effective rate of the 2 groups had statistical analysis difference(P<0.05)，and Huangkui Capsule had certain clinical effects on primary nephrotic syndrome.2)Among the 3 indexes of the 2 groups after treatment，24 h urine protein and Scr decreased significantly(P<0.05)，while Alb significantly increased(P<0.05).The decrease degree of 24 h urine protein and Scr and the improvement of Alb in the observation group were better than those of the control group(P<0.05).3)After treatment，IL-6，IL-8 and TNF-alpha of the 2 groups were all significantly down-regulated(P<0.05).The down-regulation of Huangkui capsule to IL-6，IL-8 and TNF-alpha in the observation group was better than that of the control group(P<0.05).4)After treatment，the immunization index of ANGPTL3 in the 2 groups decreased significantly(P<0.05).The decrease degree of the ANGPTL3 immunization index in the observation group was better than that of the control group(P<0.05)，and there was a positive correlation between the ANGPTL3 and IL-6，IL-8 and TNF-α.Conclusion:Huangkui Capsules has a better clinical effect in treating patients with primary nephrotic syndrome，suppressing microinflammatory state and decreasing angiopoietin like protein 3.

查看全文查看/发表评论下载PDF阅读器