健脾益肾清化法治疗慢性肾炎气虚湿热瘀阻证的临床疗效及机理研究

The Clinical Effect and Mechanism of Invigorating Spleen and Tonifying Kidney for Clearing Dampness-heat Method in the Treatment of Chronic Nephritis with Qi Deficiency,Dampness-heat and Blood Stasis Syndrome

目的观察健脾益肾清化法治疗慢性肾炎气虚湿热瘀阻证的临床疗效。方法将118例慢性肾炎气虚湿热瘀阻证患者随机分为治疗组40例,对照A组38例,对照B组40例。治疗组给予健脾益肾清化法治疗;对照A组雷公藤多苷口服;对照B组肾炎康胶囊口服。3组患者均30 d为1个疗程,共治疗2个疗程。完成疗程1周后统计中医证候疗效及疾病疗效;于治疗前后分别检测24 h Up、尿微量白蛋白、尿红细胞计数,同时检测血清IL-2、TNF-α及IL-6的水平,并与正常组进行比较。结果治疗组总有效率及疾病疗效均高于对照组(P <0.01);3组治疗后24 h Up、尿微量白蛋白均降低(P <0.05,P <0.01),以治疗组最为显著;治疗后血清IL-2均升高,TNF-α、IL-6均降低(P <0.01),但治疗组IL-2高于对照组(P <0.01,P <0.05),TNF-α和IL-6均低对照组(P <0.05,P <0.01)。结论健脾益肾清化法治疗气虚湿热瘀阻证慢性肾炎患者,能显著地降低尿蛋白排泄量,并能升高血清IL-2,降低TNF-α及IL-6水平,临床疗效优于对照组,且未发现明显不良反应。

Objective To observe the clinical effect of invigorating spleen and tonifying kidney for clearing dampness-heat method in the treatment of chronic nephritis with qi deficiency,dampness-heat and blood stasis syndrome.Methods 118 patients with chronic nephritis with qi deficiency,dampness-heat and blood stasis syndrome were randomly divided into treatment group of 40 cases,control group A of 38 cases and control group B of 40 cases.The treatment group was treated with invigorating spleen and tonifying kidney for clearing dampness-heat method,the control group A received Tripterygium polyglycosides glycosides,and control group B received Shenyankang capsule.All 3 patients were treated with 1 sessions on 30 th,with a total of 2 courses of treatment.After completing the course of treatment,the curative effect and the curative effect of TCM syndromes were measured after 1 week,and24 h Up,urinary microalbumin and urinary erythrocyte count were detected before and after therapy,and the levels of serum IL-2,TNF-α and IL-6 were detected,which was compared with the normal group.Results The total efficiency and curative effect of the treatment group were higher than that of the control group(P<0.01).The 24 h Up and urinary microalbumin of the three groups decreased(P<0.05,P<0.01) after treatment,the treatment group was the most significant.The serum IL-2 increased after treatment,TNF-α,IL-6 decreased(P<0.01),but the IL-2 of the treatment group was higher than that of the control group(P<0.01,P<0.05),TNF-α and IL-6 the treatment group were low than those of the control group(P<0.05,P<0.01).Conclusion The invigorating spleen and tonifying kidney for clearing dampness-heat method in the treatment of chronic nephritis with qi deficiency,dampness-heat and blood stasis syndrome can significantly reduce the amount of urinary protein excretion,and can increase the serum IL-2,reduce the level of TNF-α and IL-6,the clinical effect is better than the control group,and no obvious adverse reactions were found.