雷公藤多苷片合益肾活血方对IgA肾病尿IL-6、TNF-α水平的影响

Efficacy of Tripterygium glycosides tablet combined with Yishen Huoxue granule for patients with IgA nephropathy and its relation to urinary IL-6 and TNF-α

目的观察雷公藤多苷片合益肾活血方对IgA肾病患者中尿IL-6、TNF-α水平的影响,探讨雷公藤多苷片合益肾活血方治疗IgA肾病的作用机制。方法将174例IgA肾病患者按随机数字表法分为观察组96例和对照组78例。两组均以氯沙坦钾片50 mg/d作为基础治疗,观察组在基础治疗上再予以雷公藤多苷片合益肾活血方治疗,对照组则在基础治疗上予以雷公藤多苷片合益肾活血方的模拟剂治疗,疗程12周。观察治疗前后肝肾功能、尿蛋白定量、尿IL-6和TNF-α水平的变化。观察两组不良反应发生情况。结果两组患者治疗后肾功能稳定、尿蛋白定量均有下降,而观察组肾功能改善及尿蛋白下降更明显(P<0.05);观察组尿IL-6和TNF-α水平均有下降,而对照组仅尿IL-6有所下降,两组比较有统计学差异(P<0.05)。观察组不良反应发生率为15.62%,对照组为6.41%,两组间差异无统计学意义(P>0.05)。结论雷公藤多苷片合益肾活血方治疗IgA肾病能稳定肾功能、减少蛋白尿、降低尿中炎症因子IL-6和TNF-α的水平。

Objective To investigate the efficacy of Tripterygium glycosides Tablet combined with Yishen Huoxue granule for patients with IgA nephrology and its relation to urinary IL-6 and TNF-α levels. Methods One hundred and sev- enty four patients with IgA nephropathy were randomly assigned to test and control group. Patients in both groups were treated with Iosartan potassium tablets. In addition patients test group（n=96） received Tripterygium glycosides tablet and Yishen Huoxue granule for 12 weeks and those in control group （n=78） received placebos. The renal function, urine protein, IL-6 and TNF-α levels in the urine were examined before and after the treatment. Results After treatment, renal function was stabilized, urine protein contents were decreased in both group. But the improvement in renal function and the decrease of urinary protein in test group were more significant （P〈0.05）. The levels of IL-6 and TNF-α in urine were decreased in test group, while only IL-6 level was decreased in control group, there was significant difference between two groups （P〈0.05）. Conclusion The treatment of Tripterygium glycosides tablet combined with Yishen Huoxue Granule for IgA nephropathy can stabilize renal function, reduce urinary protein, IL-6 and TNF-α levels.