蛹虫草治疗慢性肾脏病的临床应用

Clinical application of Cordyceps militaris in the treatment of chronic kidney disease

目的分析蛹虫草在治疗慢性肾脏病(CKD)方面的分子机制。方法 98例CKD患者,将所有患者随机分为蛹虫草组(服用蛹虫草100 mg/d,为期3个月)和对照组(每日服用等量淀粉作安慰剂,为期3个月),每组49例。比较两组患者治疗前后肾功能指标[尿蛋白、尿素氮(BUN)、肌酐(Cr)]、血脂指标[血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、氧化还原特征指标[血清胱抑素C(Cys-C)、髓过氧化物酶(MPO)、丙二醛(MDA)、一氧化氮(NO)、超氧化物歧化酶(SOD)]水平。结果治疗3个月后,蛹虫草组尿蛋白、BUN、Cr水平分别为(1.36±0.45)g/24 h、(8.84±2.36)mmol/L、(149.1±25.5)μmol/L,均低于对照组的(2.65±0.73)g/24 h、(9.72±2.38)mmol/L、(204.0±31.8)μmol/L,差异均具有统计学意义(P<0.05)。治疗3个月后,蛹虫草组TC、TG、LDL-C分别为(4.9±0.5)、(2.0±0.6)、(1.7±0.5)mmol/L,均低于对照组的(5.9±0.7)、(2.4±0.9)、(2.2±0.6)mmol/L, HDL-C水平(1.9±0.5)mmol/L高于对照组的(1.7±0.5)mmol/L,差异均具有统计学意义(P<0.05)。蛹虫草组Cys-C、MPO、MDA水平分别为(0.8±0.2)mg/L、(14.5±3.4)mg/L、(5.4±1.9)mmol/L,均低于对照组的(1.0±0.3)mg/L、(23.3±4.3)mg/L、(8.1±2.5)mmol/L, NO(6.8±2.5)μmol/L、SOD(698.4±145.6)U/L均高于对照组的(5.8±2.1)μmol/L、(521.4±123.8)U/L,差异均具有统计学意义(P<0.05)。结论蛹虫草可通过影响脂质和氧化还原信号传导途径对CKD起保护作用,为目前评估虫草素对抑制CKD的临床试验提供了进一步的支持。

Objective To analyze the molecular mechanism of Cordyceps militaris in the treatment of chronic kidney disease(CKD). Methods A total of 98 CKD patients were randomly divided into Cordyceps militaris group(taking Cordyceps militaris 100 mg/d for 3 months) and control group(taking the same amount of starch as a placebo daily for 3 months), with 49 cases in each group. The renal function [urinary protein, blood urea nitrogen(BUN), creatinine(Cr)], blood lipids [serum total cholesterol(TC), triglycerides(TG), low density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C)], redox characteristics [serum cystatin C(Cys-C), myeloperoxidase(MPO), malondialdehyde(MDA), nitric oxide(NO), superoxide dismutase(SOD)] levels before and after treatment were compared between the two groups. Results 3 months after treatment, the urine protein, BUN, Cr levels of Cordyceps militaris group were(1.36±0.45) g/24 h,(8.84±2.36) mmol/L and(149.1±25.5) μmol/L, which were all lower than(2.65±0.73) g/24 h,(9.72±2.38) mmol/L and(204.0± 31.8) μmol/L of the control group, and the difference was statistically significant(P<0.05). 3 months after treatment, TC, TG and LDL-C of Cordyceps militaris group were(4.9±0.5),(2.0±0.6) and(1.7±0.5) mmol/L, which were all lower than(5.9±0.7),(2.4±0.9) and(2.2±0.6) mmol/L of the control group, and HDL-C(1.9± 0.5) mmol/L was higher than(1.7±0.5) mmol/L of the control group, and the difference was statistically significant(P<0.05). Cys-C(0.8±0.2) mg/L, MPO(14.5±3.4) mg/L and MDA(5.4±1.9) mmol/L of Cordyceps militaris group were lower than(1.0±0.3) mg/L,(23.3±4.3) mg/L and(8.1±2.5) mmol/L of the control group, and NO(6.8±2.5) μmol/L and SOD(698.4±145.6) U/L were higher than(5.8±2.1) μmol/L and(521.4±123.8) U/L of the control group, and the difference was statistically significant(P<0.05). Conclusion Cordyceps militaris can protect CKD by affecting lipid and redox signal transduction pathway. It provides further support for the evaluation of cordycepin to inhibit CKD clinical trials.