不同剂量百令胶囊对慢性肾脏病3~4期患者肾功能及细胞免疫的影响

Effects of different doses of Bailing Capsule on renal function and cellular immunity in patients with chronic kidney disease in stage 3~4

[目的]明确百令胶囊联合基础治疗对慢性肾脏病3~4期患者的有效性,评估百令胶囊不同剂量对慢性肾脏病的疗效差异及对细胞免疫的影响,以推进优化治疗方案。[方法]选取上海中医药大学附属龙华医院2018年3月—2019年5月收治的90例慢性肾脏病3~4期患者为研究对象,随机分为对照组、低剂量组和高剂量组各30例。对照组给予控制饮食,调节血脂、血糖及血压;纠正水及电解质紊乱、改善酸碱平衡失调、纠正贫血等常规治疗,低剂量组在对照组基础上加服百令胶囊2粒,每日3次,口服,高剂量组给予6粒,每日3次,口服。持续治疗48周,比较3组的有效率、肾功能、淋巴细胞亚群和细胞因子绝对值计数。[结果]3组患者治疗后,血肌酐、尿素氮、胱抑素C较治疗前升高,肾小球滤过率较治疗前下降,组内比较,差异具有统计学意义(P<0.05)。血肌酐、胱抑素C、肾小球滤过率组间比较,差异具有统计学意义(P<0.05)。高剂量组治疗后48周后,CD3、CD4、CD8、CD19较治疗前明显升高,差异具有统计学意义(P<0.05),低剂量组治疗48周后,CD4、CD8较治疗前升高,差异具有统计学意义(P<0.05),三组治疗48周后,组间比较CD3、CD4、CD8、CD19,差异具有统计学意义(P<0.05)。[结论]临床可以在针对慢性肾脏病基础治疗上,给予高剂量百令胶囊辅助基础治疗,可以延缓疾病进展,提升患者免疫能力,降低感染风险。

[Objective]To determine the effectiveness of Bailing Capsule combined with basic therapy in patients with stage 3-4 chronic kidney disease,to evaluate the effect of different doses of Bailing Capsule on chronic kidney disease and its effect on cellular immunity,in order to promote optimal treatment plan.[Methods]A total of 90 patients with stage 3-4 of chronic kidney disease admitted to Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine from March 20 to May 2019 were randomly divided into control group,low dose group and high dose group.The control group was given a diet to regulate blood lipids,blood sugar and blood pressure;to correct water and electrolyte disorders,to improve acid-base balance disorders,to correct anemia and other conventional treatments,the low-dose group was given Bailing capsules on the basis of the control group,2 capsules orally three times a day.In the high-dose group,6 tablets were given orally three times a day.After 48 weeks of continuous treatment,the three groups were compared for their effectiveness,renal function,lymphocyte subsets,and absolute counts of cytokines.[Results]After treatment,serum creatinine,urea nitrogen and cystatin C increased after treatment.The glomerular filtration rate decreased compared with that before treatment.The difference was statistically significant P<0.05.Serum creatinine,cystatin C,and glomerular filtration rate were compared between groups,P<0.05,and the difference was statistically significant.After 48 weeks after treatment in high dose group,CD3,CD4,CD8 and CD19 were significantly higher than before treatment,P<0.05,the difference was statistically significant.After 48 weeks of treatment in low dose group,CD4 and CD8 were higher than before treatment,P<0.05,the difference was statistically significant.After 48 weeks of treatment,CD3,CD4,CD8,and CD19 were compared between groups,P<0.05,and the difference was statistically significant.[Conclusion]Clinically,Give high-dose Bailing capsules assist basic treatment,to delay the progression of the disease.improve patient immunity and reduce the risk of infection.