实脾固肾化瘀方对慢性肾脏病患者炎症因子及瘦素水平的影响

Effects of Shipi Gushen Huayu Formula on Inflammatory Factors and Leptin in CKD Patients

目的:观察实脾固肾化瘀方对慢性肾脏病(CKD)患者炎症因子、瘦素水平及中医症候疗效的影响。方法:将64例CKD患者随机分为α酮酸联合低蛋白饮食组(LPD+KA,n=31)和实脾固肾化瘀方联合低蛋白饮食组(LPD+中药组,n=33),治疗时间为24周,观察实脾固肾化瘀方对CKD患者中医证候疗效、炎症因子、瘦素、肾功能的影响。结果:LPD+KA组、LPD+中药组均可明显升高患者血白蛋白水平(P<0.01),但后者较前者明显。LPD+中药组可降低血肌酐(P<0.01),血瘦素水平(P<0.01),提升eGFR水平(P<0.05)。两组患者TNF-α水平均下降,但LPD+中药组更优于LPD+KA组。LPD+中药组IL-6治疗后较前下降(P<0.05)。结论:实脾固肾化瘀方联合低蛋白饮食可通过降低炎症因子及瘦素、提高血白蛋白水平,从而改善CKD患者临床症状及肾功能。

Objective:To observe the effects of Shipi Gushen Huayu Formula on the levels of inflammatory factors and leptin,as well as on TCM syndromes in patients with chronic renal disease(CKD).Methods:64 CKD patients were randomly divided into the control group(alpha keto acid combined with low-protein diet,n=31)and the observation group(Shipi Gushen Huayu Formula combined with with low-protein diet,n=33).The treatment duration was 24 weeks.The effects of Shipi Gushen Huayu Formula on TCM syndrome,inflammatory factors,leptin,and on renal function were observed in the CKD patients.Results:The serum albumin levels were significantly increased after the treatment in the two groups(P<0.01),of which the change was more significant in the observation group.The serum levels of creatinine and leptin were significantly reduced(P<0.01),and the level of eGFR was greatly increased(P<0.05)in the observation group.The level of TNF-αdecreased significantly in the two groups,and the reduction was more remarkable in the observation group.The level of IL-6 decreased significantly in the observation group after the treatment,compared to that before the treatment(P<0.05).Conclusion:The combination of Shipi Gushen Huayu Formula and low-protein diet can improve the clinical symptoms and renal function of patients with CKD by reducing inflammatory factors and leptin,as well as by increasing the level of serum albumin.