百令胶囊治疗慢性移植肾肾病的临床观察

Clinical Observation on Treatment of Chronic Allograft Nephropathy with Bailing Capsule

目的观察百令胶囊(冬虫夏草菌丝体干粉制剂)对慢性移植肾肾病(chronicallograftnephropathy,CAN)的作用效果。方法对CAN患者用百令胶囊9g/天(治疗组,36例)治疗12周,与同期内未服用百令胶囊的CAN患者(对照组,15例)进行对照观察,比较两组患者治疗前后肾功能、内生肌酐清除率、尿蛋白定量、尿蛋白组分〔尿免疫球蛋白(Ig)、尿白蛋白(Alb)、尿视黄醇结合蛋白(RBP)和尿β2微球蛋白(β2MG)〕及血白细胞降低发生率的变化。结果与对照组比较,百令胶囊能明显降低CAN患者的尿蛋白〔治疗组(0.89±0.53)g/d,对照组(1.31±0.59)g/d〕和血肌酐〔治疗组(206.48±30.61)μmol/L,对照组(240.17±29.55)μmol/L〕水平,减轻肾小球性(尿Ig、Alb)和肾小管性(尿RBP、β2MG)蛋白尿,提高患者的内生肌酐清除率〔治疗组(37.33±9.91)ml/min,对照组(31.92±10.95)ml/min〕,血白细胞降低发生率(治疗组2.8%,对照组13.3%)降低。结论百令胶囊对CAN有一定的治疗作用,能减轻移植肾肾小球和肾小管损害,对患者血白细胞降低有一定的防治作用。

Objective To observe the effects of Bailing Capsule （BLC, a dry powder-formed preparation of Cordyceps sinensis mycelia） on chronic allograft nephropathy （CAN）. Methods A comparative synchronous study was conducted between 36 CAN patients treatcd with BLC 9.0 g/d （treated group） for 12 weeks and 15 CAN patients treated without BLC （control group）. The changes of renal function, endogenous creatinine clearance rate, volume of urinary protein and urinary protein components, including immune globulin （Ig） and albumin （Alb）, urinary retinol binding protein （RBP） and β2-microglobulin （β2-MG）, as well as the incidence rate of leucopenia before and after treatment in the two groups were compared. Results Compared with the control group, BLC showed more significant effects in lowering urinary protein （0.89 ± 0.53 g/d in the treated group vs 1.31 ± 0.59 g/d in the control group after treatment, the same below）, serum creatinine （206.48 ± 30.61 μmol/L vs 240.17 ± 29.55 μmol/L）, relieving glomerular and tubular proteinuria represented by levels of Ig, Alb, RBP and β2-MG in urine, increasing endogenous ereatinine clearance rate （37.33±9.91 ml/min vs 31.92±10.95 ml/min）, and reducing the incidence rate of leucopenia （2.8% vs 13.3%） in CAN patients. Conclusion BLC has certain therapeutical effect on CAN. It could relieve injury in glomerulus and tubular interstitium and has preventive and therapeutical effect on leucopenia.