前列地尔注射液联合尿毒清颗粒治疗慢性肾功能不全的临床研究

Clinical study on Alprostadil Injection combined with Niaoduqing Granules in treatment of chronic renal insufficiency

目的探讨前列地尔注射液联合尿毒清颗粒治疗慢性肾功能不全的临床疗效。方法 2012年7月—2014年2月济南市机关医院收治的慢性肾功能不全患者40例,随机分为治疗组(20例)和对照组(20例),对照组在基础治疗上口服尿毒清颗粒1包/次,3次/d。治疗组在对照组基础上静脉滴注前列地尔注射液10μg/d,静滴时间3 h以上。两组均连续治疗3周。治疗后,评价两组的临床疗效,同时比较两组治疗前后血肌酐(Scr)、内生肌酐清除率(Ccr)、尿素氮(BUN)、血红蛋白(Hb)、血浆白蛋白(Alb)和调节性T细胞(Treg)。结果治疗组和对照组的总有效率分别为75.0%、65.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者BUN、Scr均较治疗前显著降低,Ccr、Hb较治疗前显著升高,同组治疗前后差异有统计学意义(P<0.05,0.01);且治疗后治疗组BUN、Scr、Ccr的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者CD4+-Treg、CD4+CD25+CD127-Treg均较治疗前显著降低,同组治疗前后差异有统计学意义(P<0.05),且治疗组降低程度大于对照组,两组比较差异有统计学意义(P<0.05,0.01)。两组患者治疗后Th1、Th1/Th2均较治疗前显著增加,Th2显著降低,同组治疗前后差异有统计学意义(P<0.01);治疗后治疗组Th1、Th1/Th2显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论前列地尔注射液联合尿毒清颗粒对慢性肾功能不全具有较好的临床疗效,可通过调节患者的免疫功能,改善Th1/Th2水平发挥作用。

Objective To investigate the effect of Alprostadil Injection combined with Niaoduqing Granules in the treatment of chronic renal insufficiency. Methods Collecting 40 cases suffered from chronic renal insufficiency from July 2012 to February 2014 in the Authority Hospital of Jinan City, which were randomly divided into treatment （20 cases） and control （20 cases） group. Patients in the control group were po administered with Niaoduqing Granules on the basis of foundation treatment, 1 bag/time, three times daily. Patients in the treatment group were iv administered with Alprostadil Injection 10μg/d for more than 3 h on the basis of control group. The patients in the two groups were treated for 3 weeks. After the treatment, the treatment efficacy was evaluated, while Scr, Ccr, BUN, Hb, Alb, and regulatory T cell were compared between the two groups. Results The efficacies in the treatment and control groups were 75.0% and 65.0%, respectively, and there were differences between the two groups （P 〈 0.05）. After the treatment, BUN and Scr in the two groups were significantly reduced, while the Ccr and Hb were significantly increased, and the difference was statistically significant before and after the treatment in the same group （P 〈 0.05, 0.01）. And after the treatment, BUN, Scr, and Ccr in the treatment group were improved better than those in the control group, and there was significant difference between the two groups （P〈0.05）. After the treatment, CD4＋-Treg and CD4＋CD25＋CD127-Treg in the two groups were significantly reduced, and the difference was statistically significant before and after the treatment in the same group （P 〈 0.05）. And reduced degree in the treatment group was greater than that in the control group, and there was significant difference between the two groups （P〈0.05, 0.01）. Th1 and Th1/Th2 in the two groups were significantly increased, while Th2 was significantly reduced, and the differenc was statistically significant before and after the treatment in the same group （P 〈 0.01）. After the treatment, Th1 and Th1/Th2 in the treatment group were significantly higher than those in the control group, and there was significant difference between the two groups （P〈0.05）. Conclusion Alprostadil Injection combined with Niaoduqing Granules has a good clinical effect in the treatment of chronic renal insufficiency, which maybe through adjust the immune function of patients and improve the levels of Th1/Th2 to play the role.