中药汤剂对慢性肾功能衰竭患者实验室指标及血清转化生长因子β1的影响

Traditional Chinese medicine medicinal broth laboratory indexes in patients with chronic renal failure and the serum levels of Transforming growth factor-β1(TGF-β1)

目的自制中药汤剂暂定名(肾衰竭1号)对慢性肾功能衰竭患者临床症状(如乏力、纳差等)、实验室指标(血肌酐、尿素氮、血红蛋白、白蛋白等)及血清转化生长因子β1(Transforming growth factor-β1,TGF-β1)等影响,证实自制中药汤剂能够抑制肾脏纤维化而起到延缓肾功能进展的作用。方法利用回顾性空白对照、单用西药组及中药联合治疗组对照及中西药联合组的组内对照的研究方法,选取近5年来就诊于泰安市中心医院肾病一科门诊及病房、血肌酐高于正常(>133μmol∕L)但是暂时不需要肾脏替代治疗的患者做为研究对象,实验共分为3个大组,A组健康体检患者20例,B组慢性肾功能患者单用西药治疗组20例,C组西药及中药汤剂联合治疗的患者20例,依据患者临床中医辨证积分、实验室指标及血清TGF-β1在各组内变化及组间相关性研究中药汤剂的对肾脏纤维化的抑制作用。结果慢性肾衰竭患者TGF-β1(28.18±3.54)ng/ml与健康对照对照患者血清TGF-β1(22.23±1.27)ng/m l(P<0.05)比较,差异具有统计学意义,慢性肾衰竭患者单用西药组治疗3月后血清TGF-β1(0.89±1.11)ng/ml变化与健康对照对照患者血清TGF-β1(2.23±2.04)ng/ml的变化(P<0.05),差异具有统计学意义,中医药结合治疗组加用中药汤剂前血清TGF-β1(27.73±3.25)ng/ml与加用中药汤剂治疗3个月后患者血清TGF-β1(25.50±2.86)ng/ml的相比较(P<0.05),差异具有统计学意义结论自制中药汤剂(肾衰竭1号)通过抑制慢性肾衰竭患者血清TGF-β1抑制肾脏纤维化进而延缓肾功能的进展。

Objective： Homemade Chinese medicine medicinal（ broth also 1 kidney failure） in patients with chronic renal failure clinical symptoms,such as lack of power,inappetence,laboratory indexes（ serum creatinine,blood urea nitrogen,hemoglobin,albumin,etc.） and serum TGF- β1,confirmed that the homemade Chinese medicine medicinal broth can inhibit renal fibrosis and have the effect of slow progress in renal function. Methods： Using the retrospective blank control,western medicine and traditional Chinese medicine combined treatment group comparison and contrast of Chinese and western medicine combined group of research methods,serum creatinine is higher than normal（ 〉133 μmol / L） but temporarily do not need to patients with renal replacement therapy as a research object,20 patients with group A health check- up,B group of patients with chronic renal use western medicine treatment group 20 cases,C group of western medicine and traditional Chinese medicine medicinal broth 20 patients with combination therapy,ccording to the clinical syndrome differentiation of traditional Chinese medicine integral,laboratory indexes and serum TGF- β1 within each change and the correlation study of Chinese traditional medicine one set of inhibition of renal fibrosis. Results： Patients with chronic renal failure（ TGF- beta 1（ 28. 18 ＋ 3. 54） l n g / m compared with healthy controls patients serum TGF- beta 1（ 22. 23 ＋1. 27） ng / ml（ P〈0. 05） to compare,the difference statistically significant,Patients with chronic renal failure,with the western medicine group 3 months after treatment serum TGF- beta 1（ 0. 89 ＋ 1. 11） ng / ml change compared with healthy controls patients serum TGF- beta 1（ 2. 23 ＋ 2. 04） ng / ml changes（ P〈0. 05）,statistically significant differences,combination of traditional Chinese medicine treatment group used traditional Chinese medicine medicinal broth before serum TGF- beta 1（ 27. 73 ＋ 3. 25） n g / ml and add three months after the patients treated with traditional Chinese medicine medicinal broth serum TGF- beta 1（ 25. 50 ＋ 2. 86） n g / ml compared（ P〈0. 05）,the difference is statistically significant. Conclusion： Homemade Chinese medicine medicina（ broth also 1 kidney failure） by inhibiting the serum of patients with chronic renal failure TGF- β1and delay the progress of renal function.