参蛭活血汤联合氯沙坦钾片治疗过敏性紫癜性肾炎对患者炎症因子、肾功能的影响分析

Effect of Shenzhi Huoxue Decoction Combined with Losartan Potassium Tablet on Inflammatory Factors and Renal Function for Patients with Henoch-schonlein Purpura Nephritis

目的:观察参蛭活血汤联合氯沙坦钾片治疗过敏性紫癜性肾炎对患者炎症因子、肾功能的影响,为临床治疗提供参考。方法:选取我院2017年6月~2019年4月收治的过敏性紫癜性肾炎患者108例,根据治疗方法分为两组,每组54例。两组患者均给予调整生活方式、控制饮食、控制血压等常规治疗,单药组加用氯沙坦钾片治疗,联合组加用参蛭活血汤联合氯沙坦钾片治疗。记录两组治疗前后中医证候量化积分、炎症因子、肾功能指标水平变化,并统计两组临床治疗总有效率。结果:治疗后,两组皮肤有瘀点或瘀斑、五心烦热、神疲乏力及咽干口渴积分及单核细胞趋化蛋白-1(MCP-1)、高敏-C反应蛋白(hs-CRP)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、24h尿蛋白定量(24hpro)、尿红细胞计数、尿微量白蛋白(mAlb)水平较治疗前下降,联合组皮肤有瘀点或瘀斑、五心烦热、神疲乏力及咽干口渴积分及MCP-1、hs-CRP、IL-17、TNF-α、24hpro、尿红细胞计数、mAlb水平低于单药组(P<0.05)。治疗后,联合组总有效率(92.59%)高于单药组(77.78%),差异具有统计学意义(P<0.05)。结论:参蛭活血汤联合氯沙坦钾片治疗过敏性紫癜性肾炎可减轻炎症反应,减少蛋白尿,提高疗效。

Objective:To observe the effect of Shenqi Huoxue Decoction combined with Losartan Potassium Tablet on the inflammatory factors and renal function for patients with Henoch-Schonlein purpura nephritis,and to provide reference for clinical treatment.Methods:108 patients with Henoch-Schonlein purpura nephritis treated in our hospital from June 2017 to April 2019 were divided into two groups according to the treatment method.54 patients in each group were treated with routine treatment such as adjusting life style,controlling diet and controlling blood pressure.The single drug group was treated with Losartan Potassium Tablets,and the combined group was treated with Shenzhi Huoxue Decoction combined with Losartan Potassium Tablets.The quantitative scores of TCM syndromes,inflammatory factors and renal function indexes in the two groups were recorded before and after treatment,and the total effective rate of clinical treatment in the two groups was counted.Results:After treatment,2 groups of skin had blood stasis or ecchymosis,five upset heat,fatigue of God,and thirst for pharyngeal and dry throat,and monocyte chemoattractant protein-1(MCP-1),high-sensitivity-C reactive protein(hs-CRP),interleukin-17(IL-17),tumor necrosis factor-1(TNF-1),and 24-hour urinary protein quantification(24 hpro).The urine red blood cell count and the level of microalbumin(mAlb)in the combined group were lower than that before the treatment.The skin of the combined group had blood stasis or ecchymosis,five vexation heat,fatigue of God and thirst for pharynx and thirst,and MCP-1,hs-CRP,IL-17 and TNF-1,24 hpro,urine red blood cell count and mAlb level were lower than that of the single group(P<0.05).After treatment,the total effective rate of the combined group(92.59%)was higher than that of the single group(77.78%),and the difference was statistically significant(P<0.05).Conclusion:Shenzhi Huoxue Decoction combined with Losartan Potassium Tablet in the treatment of Henoch-Schonlein purpura nephritis can reduce inflammatory reaction,reduce albuminuria and improve the curative effect.