清肾汤对慢性肾功能衰竭急剧加重湿热证患者血清瘦素和白细胞介素-6的干预作用

Effect of Qingshen decoctionon(清肾汤) serum leptin and interleukin-6 in patients with chronic renal failure and sharp deterioration of damp-heat syndrome(湿热证)

目的:观察慢性肾功能衰竭(CRF)急剧加重湿热证患者血清瘦素(L eptin)、白细胞介素6(IL 6 )水平变化及清肾汤的干预作用。方法:6 0例CRF急剧加重湿热证患者随机分为治疗组与对照组各30例,并设正常对照组2 0例。治疗组与对照组均使用中药保留灌肠,治疗组加用清肾汤。检测治疗组与对照组治疗前后L eptin与IL 6水平变化情况,并与正常组比较。结果:CRF急剧加重湿热证患者血L eptin与IL 6水平均明显高于正常组(P均<0 .0 1) ,治疗组治疗后患者血L eptin与IL 6均明显下降〔L eptin由(2 5 .95±11.2 3) ng/ L 降至(19.17±9.6 0 ) ng/ L,IL 6由(88.0 9±10 .2 0 ) ng/ L 降至(77.81±8.73) ng/ L;P均<0 .0 1〕;对照组治疗前后差异无显著性〔L eptin由(2 4 .81±10 .5 4 ) ng/ L降至(2 1.34±10 .0 5 ) ng/ L ,IL 6由(88.2 3±10 .36 ) ng/ L降至(82 .5 3±8.6 2 ) ng/ L ;P均>0 .0 5〕。两组相比,治疗后治疗组患者血L eptin与IL 6水平均较对照组明显下降(P均<0 .0 5 )。结论:CRF急剧加重湿热证患者血L eptin与IL 6均明显升高,清肾汤可降低其水平,这是该方能明显减轻患者恶心呕吐、食少纳呆等症状的机制之一。

Objective: To observe the changes of serum leptin and interleukin6( IL6) and the curative efficacy of Qingshen decoction(清肾汤,QSD) in patients with chronic renal failure (CRF) and sharp deterioration of dampheat syndrome.(湿热证,DHS) Methods: Sixty cases with DHS and CRF were randomly divided into treatment group (n=30) and control group (n=30), and there was a normal control group (n=20). The treatment group and the control group were treated with traditional Chinese medicinal herb through enema. QSD was used additionally in the treatment group. The changes of serum leptin and IL6 were observed in treatment group and control group, and compared with that in the normal control. Results: The level of serum leptin and IL6 in patients with DHS and CRF were obviously higher compared to those of the normal control group(all P<0.01). After QSD treatment, the level of leptin and IL6 were decreased obviously in treatment group 〔leptin decreased from(25.95±11.23)ng/L to(19.17±9.60)ng/L, IL6 decreased from(88.09±10.20)ng/L to(77.81±8.73)ng/L, both P<0.01〕. In the control group, there was no significant difference of the changes of leptin and IL6 〔leptin decreased from(24.81±10.54)ng/L to(21.34±10.05)ng/L, IL6 decreased from(88.23±10.36)ng/L to(82.53±8.62)ng/L, both P>0.05〕. In comparison of the two groups, after the treatment the levels of leptin and IL6 were decreased more significantly in the treatment group than that in the control group (both P<0.05). Conclusion: The level of serum leptin and IL6 increase obviously in patients with sharp deterioration of DHS and CRF, and QSD can decrease them. That is one of the mechanisms of QSD that can decrease the symptoms such as nausea, vomiting, anorexia, etc.