活血养阴剂治疗慢性肾小球肾炎及对患者血清VEGF表达的影响

Huoxue Yangyin Decoction Treating Chronic Glomerulonephritis and Influence on VEGF

目的:观察活血养阴剂治疗慢性肾小球肾炎及对患者血清血管内皮生长因子(VEGF)表达的影响。方法:经肾活检确诊慢性肾小球肾炎患者40例,对照组20例予激素口服;治疗组20例在对照组治疗的基础上加服活血养阴剂,连续治疗2个月。结果:两组治疗后临床症状均有改善,但治疗组改善更为显著(P<0.05)。微小病变型肾小球肾炎(MCGN)、系膜增生性肾小球肾炎(MsPGN)、局灶节段硬化性肾炎(FSGS)、膜性肾病(MN)、血清VEGF的表达均高于正常对照组(P<0.05),且与尿蛋白定量及血肌酐均呈显著正相关(P<0.05),但硬化性肾小球肾炎(SGN)组患者血清VEGF表达较正常对照组降低,与尿蛋白及血肌酐水平无明显相关性(P>0.05)。结论:VEGF可能在病理类型为MCGN、MsPGN、FSGS、MN的慢性肾炎中是导致蛋白尿及肾功能恶化的病理因素之一,活血养阴剂能抑制VEGF的分泌和表达,从而减少蛋白尿,延缓疾病进展。

Objective：To treat chronic glomerulonephritis with Huoxue Yangyin Decoction and to observe the influence on vascular endothelial growth factor.Methods：We selected 40 cases of chronic glomerulonephritis patients confirmed by kidney biopsy.The patients were divided into two groups.20 cases of the control group were routinely treated with prednisolone,20 cases in the observation group were added with Huoxue Yangyin decoction.All of them were treated for two months.Results：The clinic symptoms of two groups improved,the observation group improved significantly（P0.05）.The levels of VEGF of minimal change glomerulonephritis（MCGN）、Mesangioproliferative glomerulonephritis（MsPGN）、focal segment glomerulonephritis（FSGS）and membranous glomerulonephritis（MN）were higher than normals（P0.05）.The levels of VEGF were significantly correlated with Scr（P0.05）,The levels of VEGF were also significantly correlated with UTP（P0.05）.The levels of VEGF of sclerosing glomerulonephritis（SGN）were lower than normals（P0.05）.The levels of VEGF have no correlation with Scr and UTP（P0.05）.Conclusion：VEGF might be one of mechanism of causing proteinuria and renal function aggravated in the chronic nephritis which pathology type was MCGN、MsPGN、FSGS or MN.Huoxue Yangyin decoction could restrain the secretion and expression of VEGF and reduce the proteinuria and slow down progression of disease.