参地颗粒对慢性肾炎脾肾亏虚证患者血清VEGF、尿EGF的干预作用

Effect of Shendi Granule on Serum Vascular Endothelial Growth Factor and Urinary Epidermal Growth Factor in Patients with Chronic Glomerulonephritis of Spleen-kidney Deficiency Syndrome

目的:观察慢性肾小球肾炎(CGN)脾肾亏虚证患者血清血管内皮生长因子(VEGF)和尿表皮生长因子(EGF)的变化及参地颗粒的干预作用。方法:64例CGN脾肾亏虚证患者随机分为对照组和治疗组各32例,实际完成61例(对照组31例,治疗组30例),并设正常组20例。治疗组口服参地颗粒,对照组口服氯沙坦钾片,疗程均为8周,观察治疗前后临床疗效、24 h尿蛋白定量、尿红细胞计数、血清VEGF和尿EGF水平变化,并与正常组比较。结果:治疗组临床疾病总有效率和中医证候疗效总有效率均为86.67%,优于对照组的61.30%(P<0.05);治疗组治疗后24 h尿蛋白定量、尿红细胞计数均较治疗前降低(P<0.05),而对照组治疗后24 h尿蛋白定量较治疗前降低(P<0.05),但尿红细胞计数降低不明显(P>0.05);两组患者治疗前血清VEGF和尿EGF水平明显高于正常组(P<0.01),治疗后两组血清VEGF和尿EGF水平均下降(P<0.05),且治疗组优于对照组(P<0.05)。结论:CGN脾肾亏虚证患者血清VEGF、尿EGF水平上升,参地颗粒可显著降低患者血清VEGF、尿EGF水平,降低中医证候积分,改善临床症状,其机制之一可能与其降低患者血清VEGF、尿EGF水平有关。

Objective：To observe the effect of Shendi Granule on serum vascular endothelial growth factor（VEGF）and uri-nary epidermal growth factor（EGF）in Patients with chronic glomerulonephritis of spleen - kidney deficiency syndrome. Methods：64 cases with chronic glomerulonephritis of spleen - kidney deficiency syndrome were equally randomized to the control group and the treated group,61 cases were completed,31 cases in the control group and 30 cases in the treated group. Patients in the control group were given losartan potassium tablets,and in the treated group were given Shendi granule. The therapeutic course for all was 8 weeks. Besides,a group of 20 healthy persons was set up for normal control. The clinical Efficacy,quantitate of 24 hours urine protein,uri-nary red cells,levels of VEGF and EGF were observed in 61 cases before and after the treatment. Results：Both the total effective rate on disease and on Chinese medicine syndrome in the treated group were 86. 67% ,significantly higher than those in the control group, 61. 30% ,respectively,showing significant differences between groups（P 〈 0. 05）. The levels of quantitate of 24 hours urine protein and urinary red cells reduced markedly after treatment in treated group（P 〈 0. 05）,urinary red cells was no change after treatment in control group（P 〉 0. 05）. The levels of serum VEGF and urinary EGF were obviously higher before treatment,as compared to those in the normal control group（P 〈 0. 05）,serum VEGF and urinary EGF reduced markedly after treatment in both treated group and control group（P 〈 0. 05）,but the changes in the treated group were more significant（P 〈 0. 05）. Conclusion：Shendi Granule could ameliorate clinical symptoms with chronic glomerulonephritis of spleen - kidney deficiency syndrome. The mechanism may be related to reduce of serum VEGF and urinary EGF levels.