肾康灵对肾虚血瘀型慢性肾脏病2-4期患者血TGF-β1和BMP-7的影响

Effect of Shenkangling on TGF-β1 and BMP-7 in CKD2-4 Patients with Kidney Deficiency and Blood Stasis

目的探讨慢性肾脏病(CKD)2-4期患者采用肾康灵治疗后肾功能、转化生长因子β1(TGF-β1)、人骨形态发生蛋白-7(BMP-7)的变化。方法肾虚血瘀型慢性肾脏病2-4期患者106例作为研究对象,按照患者意愿分为2组,对照组42例,观察组64例。观察组采用基础治疗加肾康灵,每次8片,日3次。常规治疗3月后进行评价。测定患者血浆肌酐(Scr)、尿素氮(BUN)、计算肾小球滤过率(e GFR)和血清TGF-β1、BMP-7。结果治疗后2组证候积分均明显降低(P <0.01),观察组治疗后积分比对照组降低更明显(P <0.01)。治疗前后对照组Scr、BUN、eGFR无明显差异(P> 0.05);观察组治疗后Scr、BUN明显降低(P <0.05),eGFR明显升高(P <0.05)。对照组治疗前后血清TGF-β1和BMP-7无明显差异(P> 0.05);观察组治疗后血清TGF-β1明显降低(P <0.05),BMP-7明显升高(P <0.05)。结论肾康灵可能通过平衡TGF-β1和BMP-7,从而改善肾功能和中医证候。

Objectives To investigate the changes of renal function, transforming growth factor-beta 1(TGF-β1) and bone morphogenetic protein-7(BMP-7) in patients with chronic kidney disease(CKD) stage 2-4 treated with Shenkangling. Methods 106 patients with CKD2-4 stage of kidney deficiency and blood stasis were divided into two groups according to patients’ will 42 cases in the control group and 64 cases in the observation group. Observation group was treated with basic therapy plus Shenkangling, 8 tablets per time, 3 times per day. Routine treatment was evaluated after 3 months. Serum creatinine(Scr), urea(BUN), glomerular filtration rate(eGFR), serum TGF-β1 and BMP-7 were measured. Results After treatment, the scores of symptoms in both groups decreased significantly(P<0.01), and the scores in the observation group decreased more significantly than those in the control group(P<0.01). There was no significant difference in Scr, BUN and eGFR between the control group before and after treatment(P>0.05).Scr and BUN in the observation group decreased significantly after treatment(P<0.05), and eGFR increased significantly(P<0.05). There was no significant difference in serum TGF-β1 and BMP-7 between the two groups before treatment(P>0.05). There was no significant dif ference in serum TGF-β1 and BMP-7 between the control group before treatment(P>0.05). TGF-β1 in the observation group decreased significantly after treatment(P<0.05), and BMP-7 increased significantly(P<0.05).Conclusion Shenkangling may improve renal function and TCM symptoms by balancing fibrosis factors.