肾病1号方加减对肝肾阴虚型重症IgA肾病患者临床疗效及肾纤维化机制指标的影响

Treatment of Severe IgA Nephropathy with Syndrome of Yin Deficiency of Liver and Kidney with Nephrotic Prescription No.1

目的观察肾病1号方加减对重症IgA肾病患者的临床疗效及肾纤维化机制指标的影响。方法将40例患者病例随机分为治疗组和对照组,各20例,治疗组予以肾病1号方和科素亚治疗,对照组予以肾病1号方模拟剂和科素亚治疗,治疗前和治疗后24周时,检测血尿白细胞介素-6(IL-6)、白细胞介素-10(IL-10),尿转化生长因子-β1(TGF-β1);治疗24周后进行疗效评价。结果与治疗前比较,治疗组中医证候积分下降明显(P <0.001);与对照组相比,治疗组中医证候积分明显下降(P <0.05)。2组治疗24周后,治疗组总有效率80%,优于对照组的15%(P <0.05)。与治疗前比较,治疗组血IL-6、尿IL-6、尿TGF-β1水平均低于治疗前(P <0.05);与对照组比较,治疗组血IL-6、尿IL-6、尿TGF-β1的水平明显降低(P <0.05)。结论肾病1号方加减能改善重症IgA肾病的症状及体征,可以调节患者血IL-6、尿TGF-β1的水平。

Objective To observe the effect of Nephrotic Prescription No.1 on severe IgA nephropathy and the mechanism of renal fibrosis. Methods Forty patients were randomly divided into the treatment group and the control group, 20 in each group. The treatment group was treated with Nephrotic Prescription No.1 and Cozaar, and the control group was treated with the stimulant of Nephrotic Prescription No.1 and Cozaar. Before and 24 weeks after treatment, the levels of serum IL-6, urinary IL-6, serum IL-10, urinary IL-10 and urinary TGF-β 1 were measured, and the curative effect was evaluated after 24 weeks of treatment. Results Compared with before treatment, the traditional Chinese medicine (TCM) syndrome scores in the treatment group decreased significantly ( P <0.001). Compared with the control group, the TCM syndrome scores in the treatment group decreased significantly ( P < 0.05). After two weeks of treatment, the total effective rate of the treatment group was 80% and 15% in the control group. The levels of serum IL-6, urinary IL-6 and urinary TGF-β 1 in the treatment group were lower those before treatment ( P < 0.05), and lower than those in the control group ( P < 0.05). Conclusion The modified Nephrotic Prescription No.1 can improve the symptoms and signs of severe IgA nephropathy, and can regulate the level of urinary IL-6 and urinary TGF- β 1 .