加味当归补血汤调节IgA肾病肾虚血瘀证患者细胞因子的临床研究

A clinical study on the effects of supplemented Danggui Buxue Decoction on cytokines in IgA glomerulonephritic patients of kidney deficiency and blood stasis pattern

目的研究加味当归补血汤对Ig A肾病患者的抑制细胞因子聚集及延缓肾脏纤维化的保护作用。方法将经过肾活检证实的Ig A肾病患者进行随机分组治疗,对照组仅使用基础治疗,治疗组在基础治疗的基础上加用加味当归补血汤。在治疗终点应用统计学方法分析2组患者血、尿细胞因子及纤维化相关指标,并进行组间疗效差异的比较。结果治疗组和对照组均可减少24 h尿蛋白水平,治疗组由治疗前的(5.78±1.10)g下降至(1.25±0.67)g,而对照组由(5.25±1.21)g下降至(2.09±0.89)g。同时具有调节患者细胞因子和纤维化相关指标如单核细胞趋化蛋白-1(MCP-1)、巨噬细胞移动抑制因子(MIF)、转化生长因子-β1(TGF-β1)、透明质酸酶(HA)、层粘连蛋白(LN)、胶原Ⅳ(Col-Ⅳ)、Ⅲ型前胶原N端肽P(PⅢNP)等的作用疗效显著,治疗前后自身对照改善均具有统计学意义(P<0.05)。2组治疗后以上数据的组间比较,除尿液LN外组间比较均有统计学意义,分析其在Ig A肾病肾脏纤维化的意义表明治疗组的疗效优于对照组。结论中药和西药治疗均对Ig A肾病具有较好的抑制细胞因子聚集及延缓肾脏纤维化的保护作用,配合中药加味当归补血汤治疗可以明显提高临床疗效。

Objective To investigate the effects of supplemented Danggui Buxue Tang （Chinese angelica blood-tonifying decoction）on inhibition of cytokine congregation and kidney cirrhosis in patients with IgA glomerulonephritis.Methods Histopathologically confirmed IgA grlomerulonephritic patients were ran-domly divided into two groups.Both groups received routine treatment while treatment group was given an extra supplemented Danggui Buxue Tang.Outcome measures were urine and blood cytokines and fibrosis related parameters to compare the differences between groups.Results 24h urine protein level was both reduced in treatment group （from 5.78 ±1.10 g to 1.25 ±0.67 g）and control group （from 5.25 ±1.21 g to 2.09 ±0.89 g）.Cytokines and fibrosis related parameters including MCP-1,MIF,TGF-β1,HA,＆amp;nbsp;LN,Col-IV,and PIIINP were all significantly improved after intervention in both groups respectively （P〈0.05）.The difference between two groups was significant in all factors except LN.Conclusion Com-bined treatment of with conventional and Chinese medicine is effective for IgA glomerulonephritis in terms of inhibiting cytokine aggregation and delay kidney cirrhosis.Adding supplemented Danggui Buxue Tang according to TCMpattern identification seems to improve effectiveness significantly.