消瘀泄浊饮对CKD2～4期患者血清IL-6、IL-17、IL-10及微炎症状态的影响

Effect of Xiaoyu Xiezhuo Decoction on Serum Interleukin 6,Interleukin 17,Interleukin 10 and Micro Inflammatory State of Patients with Chronic Kidney Disease (Stage 2 ～ 4)

目的:观察消瘀泄浊饮对慢性肾脏病(chronic kidney disease,CKD)2~4期患者血清白介素6(IL-6)、白介素7(IL-17)、白介素10(IL-10)及微炎症状态的影响。方法:选取CKD2~4期"气虚夹瘀"型患者共80例,按随机数字表开放性分为治疗组和对照组各40例。对照组予优质低蛋白饮食及开同治疗,治疗组在对照组的基础上予中药汤剂消瘀泄浊饮治疗。治疗12周后,比较两组治疗前后IL-6、IL-17、IL-10、超敏C反应蛋白(hs-CRP)含量和常规指标改善情况。结果:(1)治疗组总有效率70%、中医疗效症候积分较对照组明显改善(P<0.05);(2)治疗组hs-CRP、IL-6、IL-17水平较治疗前明显下降(P<0.05),且低于对照组治疗后(P<0.05);(3)治疗组IL-10水平较前明显上升(P<0.05),且高于对照组治疗后(P<0.05);(4)治疗组血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白(24 h Upr)较治疗前下降,白蛋白(Alb)较前上升(P<0.05),且治疗组Scr、BUN、24 h Upr水平低于对照组,Alb水平高于对照组,差异具有统计学意义(P<0.05);(5)两组治疗后低密度脂蛋白(LDL)水平均较治疗前下降(P<0.05)。结论:消瘀泄浊饮通过降低CKD2~4期患者血清IL-6、IL-17水平,提高IL-10血清含量,同时降低Scr、BUN、24 h Upr,延缓肾功能进展,改善"气虚夹瘀"型患者的中医症状。

Objective:Objective To treat stage 2~4 CKD patients with Xiaoyu Xiezhuo decoction and observe its effect on serum interleukin 6,interleukin 17,interleukin 10 and micro inflammatory state.Methods:Subjects The clinical data of 80 pre-dialysis patients with stage 2-4 CKD were collected in the First Affiliated Hospital of Zhejiang Chinese Medical University.Methods The80 patients were randomly divided into two groups,the treatment group of 40 patients,high quality low-protein mealcombined with keto-analogues of essential amino acids and treated with Xiaoyu Xiezhuo decoction.The control group’s 40 cases,high quality low-protein mealcombined with keto-analogues of essential amino acids but don’t treated with Xiaoyu Xiezhuo decoction.After 12 weeks of treatment,compared serum IL-6,IL-17,IL-10,hs-CRP and renal function before and after treatment.Results:(1)The total effective rate of the treatment group was 70.0%,The curative effect symptom scores of TCM in the treatment group were significantly improved compared with the control group(P<0.05).(2)The level of hs-CRP,IL-6 and IL-17 in the treatment group was lower than that before the treatment(P<0.05),and it was lower than that of the control group(P<0.05).(3)The level of IL-10 in the treatment group was higher than that before(P<0.05),and was higher than that in the control group(P<0.05).(4)The Scr,BUN and 24 h Upr in the treatment group were lower than those before the treatment,and the Alb was higher than that before the treatment(P<0.05).The level of Scr,BUN and 24 h Upr in the treatment group was lower than that of the control group,and the level of Alb was higher than that of the control group,with a significant difference(P<0.05).(5)The level of LDL in these two groups was lower than before(P<0.05).Conclusion:The Xiaoyu Xiezhuo decoction can reduce the level of serum IL-6 and IL-17,and improve the state of Micro inflammatory in patients with CKD2~4.It can also decrease the Scr,BUN,24 h Upr level in CKD patients and delay the progression of kidney function and improve the symptoms.The Xiaoyu Xiezhuo decoction can be used as an effective treatment for the improvement of micro inflammation in patients with CKD2~4.