补肾祛瘀活血汤辅助治疗慢性肾小球肾炎对患者血清炎性因子及细胞免疫功能的影响

Effects of Bushen Quyu Huoxue Decoction as adjuvant treatment onserum inflammatory factors and cellular immune function inpatients with chronic glomerulonephritis

目的探讨补肾祛瘀活血汤联合氯沙坦对气虚血瘀型慢性肾小球肾炎患者血清白介素-6(interleulin,IL-6)与肿瘤坏死因子-α(tumor necrosis factor,TNF-α)及细胞免疫功能的影响。方法选取绍兴文理学院附属医院于2017年4月至2018年4月收治的气虚血瘀型慢性肾小球肾炎患者74例,根据随机表法分为观察组37例与对照组37例。对照组采用氯沙坦治疗,观察组在对照组基础上结合补肾祛瘀活血汤治疗。两组疗程均为3个月,比较两组治疗前后肾功能指标、24h尿蛋白定量、IL-6、TNF-α和细胞免疫功能变化。结果观察组总有效率94.60%高于对照组70.27%(χ~2=7.559,P<0.05)。观察组治疗后Scr(114.24±12.49)μmol/L和BUN(6.73±0.48)mmol/L低于对照组(143.76±18.84)μmol/L和(8.39±0.73)mmol/L(P<0.05)。观察组治疗后24h尿蛋白定量(0.83±0.14)g低于对照组(1.32±0.28)g(P<0.05)。观察组治疗后血清IL-6(163.29±18.37)ng/L和TNF-α(2.01±0.45)g/L低于对照组(221.34±26.48)pg/ml和(3.09±0.31)g/L(P<0.05)。观察组治疗后CD3^+(69.71±2.76)%、CD4^+(38.97±1.65)%和CD4^+/CD8^+(1.74±0.16)高于对照组(63.87±1.83)%、(34.54±2.02)%和(1.45±0.13)(P<0.05)。结论补肾祛瘀活血汤联合氯沙坦对气虚血瘀型慢性肾小球肾炎患者疗效显著,且可降低血清IL-6和TNF-α水平,及改善细胞免疫功能。

Objective To discuss the effects of Bushen Quyu Huoxue Decoction as adjuvant treatment on serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and cellular immune function in patients with chronic glomerulonephritis of Qixu Xueyu type.Methods Seventy-four patients with chronic glomerulonephritis of Qixu Xueyu type stasis treated in our hospital from April 2017to April 2018were enrolled and divided into observation group(37cases)and control group(37cases)according to the random table method.Patients in the control group were treated with losartan,and those in observation group were treated with losartan along with Bushen Quyu Huoxue Decoction for 3months.The renal function,24-hour urinary protein,IL-6,TNF-αand cellular immune function before and after treatment were compared between the two groups.Results The overall effective rate of the observation group was 94.60%,which was higher than that of the control group(70.27%,χ2=7.559,P<0.05).After treatment,the serum levels of Scr and BUN,were significantly lower in the observation group than those in the control group(114.24+12.49 vs 143.76+18.84)μmol/L;(6.73+0.48 vs 8.39+0.73)mmol/L;(P<0.05).After treatment,the 24-hour urinary protein content was significantly lower in the observation group than those in the control group(0.83+0.14 vs 1.32+0.28g,P<0.05).Meanwhile,the serum levels of IL-6TNF-αwere also lower in the observation group compared to those in the control group(163.29+18.37 vs 221.34+26.48)ng/L;(2.01+0.45 vs 3.09+0.31)g/L;(P<0.05).After treatment,the percentage of CD3+,CD4+and CD4+/CD8+ratio were(69.71+2.76)%,(38.97+1.65)%and(1.74+0.16)in the observation group,which were all higher than those in the control group(63.87+1.83)%,(34.54+2.02)%,(1.45+0.13),the differences were statistically significant(P<0.05).Conclusions Bushen Quyu Huoxue Decoction combined with Losartan is effective in the treatment of patients with chronic glomerulonephritis of Qixu Xueyu type.which can reduce the serum levels of IL-6and TNF-α,and improve the cellular immune function.