肾康颗粒对慢性肾炎脾肾亏虚证患者血清超敏C-反应蛋白及凝血功能的影响

Effects of Shenkang Granule on Serum Level of High-sensitivity C-reactive Protein and Coagulation Function in Patients with Chronic Nephritis and Spleen and Kidney Deficiency Syndrome

目的观察慢性肾炎脾肾亏虚证患者血清超敏C-反应蛋白(high-sensitive C-reactive protein,hsCRP)和凝血功能的变化及肾康颗粒对其干预作用。方法选择慢性肾炎脾肾亏虚证患者55例,随机将其分为对照组28例和试验组27例,并设正常组20例。两组患者均给予常规基础治疗,试验组在此基础上加服肾康颗粒,疗程共8周。比较两组治疗后临床疗效,检测治疗前后尿白蛋白肌酐比值(urinary albumin to creatinine ratio,UACR)、24h尿蛋白定量(24-hour urine protein,24hUP)、血白蛋白(albumin,Alb)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)、hs-CRP、凝血酶原时间(prothrombin time,PT)、部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)和纤维蛋白原(fibrinogen,Fib)的变化。结果试验组临床疗效显著优于对照组(P<0.05)。两组患者治疗后24hUP、UACR均较治疗前降低,血Alb较治疗前升高(P<0.05),试验组改善程度优于对照组(P<0.05)。两组患者治疗前血清hs-CRP、Fib水平较正常组显著升高,PT、APTT、TT明显缩短(P<0.05),治疗后两组血清hs-CRP、Fib水平较治疗前明显下降,PT、APTT、TT较治疗前明显延长(P<0.05),试验组改善程度优于对照组(P<0.05)。结论肾康颗粒能有效改善慢性肾炎脾肾亏虚证患者的临床症状,减少尿蛋白,其作用机制可能与降低血清hs-CRP,抑制体内微炎性反应,改善高凝状态有关。

Objective To investigate the changes in the serum level of high-sensitivity C-reactive protein （hs-CRP） and coagulation function in patients with chronic nephritis and spleen and kidney deficiency syndrome, as well as the therapeutic effect of Shenkang Granule.Methods A total of 55 patients with chronic nephritis and spleen and kidney deficiency syndrome were enrolled and randomly divided into control group with 28 patients and experimental group with 27 patients, and another 20 healthy persons were enrolled as normal control group.The patients in both groups were given conventional basic treatment, and those in the experimental group were given Shenkang Granule in addition.The course of treatment was 8 weeks.The clinical outcome was compared between the two groups, and the changes in urinary albumin-to-creatinine ratio （UACR）, 24-hour urinary protein （24hUP）, serum albumin （Alb）, blood urea nitrogen, serum creatinine, hs-CRP, prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, and fibrinogen （Fib） after treatment were measured for both groups.Results The experimental group had significantly better clinical outcomes than the control group （P〈0.05）.After treatment, the experimental group and the control group had significant reductions in 24hUP and UACR and a significant increase in serum Alb level （P〈0.05）, and the experimental group had significantly better improvements than the control group （P〈0.05）.Compared with the normal control group, the experimental group and the control group had significantly higher serum levels of hs-CRP and Fib and significantly shorter PT, APTT, and TT before treatment （P〈0.05）.After treatment, the experimental group and the control group had significant reductions in the serum levels of hs-CRP and Fib and significant increases in PT, APTT, and TT （P〈0.05）, and the experimental group had significantly better improvements than the control group （P〈0.05）.Conclusion In patients with chronic nephritis and spleen and kidney deficiency syndrome, Shenkang Granule can effectively improve their clinical symptoms and reduce urinary protein, possibly by reducing serum hs-CRP level, inhibiting in vivo inflammatory response, and improving hypercoagulability.