益气活血方联合西药治疗慢性肾脏病对患者氧化应激及微炎症状态的影响

Effects of Yiqi Huoxue Recipe combined with western medicine on oxidative stress and micro-inflammatory status in patients with chronic kidney disease

目的研究益气活血方联合西药治疗慢性肾脏病(CKD)对患者氧化应激及微炎症状态的影响。方法选择2018年4月至2020年2月上海市浦东新区浦南医院收治的170例CKD患者,按照随机数表法分为观察组和对照组,每组85例。对照组患者采用西药治疗,观察组患者采用益气活血方联合西药治疗,两组患者均治疗1个月。比较两组患者治疗后的临床疗效,以及治疗前后的肾功能[血清肌酐(Scr)、尿素氮(BUN)、肌酐尿酸(UA)水平、内生肌酐清除率(Ccr)]、氧化应激[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)]、微炎症状态[白细胞介素-6(IL-6),白细胞介素-17(IL-17)、γ-干扰素(IFN-γ)]和治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为85.88%,明显高于对照组的63.53%,差异具有统计学意义(P<0.05);治疗后,观察组患者的Scr、BUN、UA水平分别为(143.49±25.63)μmol/L、(10.34±1.52)mmol/L、(386.17±54.52)μmol/L,明显低于对照组的(174.37±29.48)μmol/L、(12.41±1.83)mmol/L、(415.46±63.81)μmol/L,Ccr水平为(48.51±10.58)mL/min,明显高于对照组的(42.35±9.26)mL/min,差异均具有统计学意义(P<0.05);治疗后,观察组患者的MDA水平为(4.32±0.74)mmol/L,明显低于对照组的(4.87±0.82)mmol/L,SOD、GSH-Px水平分别为(86.45±1.82)IU/mL、(248.32±6.64)IU/mL,明显高于对照组的(79.51±1.54)IU/mL、(221.52±8.13)IU/mL,差异均有统计学意义(P<0.05);治疗后,观察组患者的IL-6、IL-7、IFN-γ水平分别为(130.25±24.13)ng/L、(38.19±8.25)ng/L、(21.36±3.49)ng/L,明显低于对照组的(182.57±28.49)ng/L、(77.42±14.57)ng/L、(27.18±5.22)ng/L,差异均有统计学意义(P<0.05);治疗期间两组患者均无明显不良反应发生。结论益气活血方联合西药治疗CKD能够有效改善患者的肾功能及氧化应激状态,减轻炎症水平,临床治疗效果好。

Objective To study the effects of Yiqi Huoxue Recipe combined with western medicine on oxidative stress and micro-inflammation status in patients with chronic kidney disease(CKD).Methods A total of 170 patients with CKD admitted to South Pudong Hospital of Pudong New District of Shanghai were enrolled between April 2018 and February 2020.They were divided into observation group and control group according to random number table method,with 85 patients in each group.The patients in the control group were treated with western medicine,while those in the observation group were treated with Yiqi Huoxue Recipe and western medicine.Both groups were treated for 1 month.The clinical curative effect after treatment,kidney function[serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),endogenous creatinine clearance(Ccr)],oxidative stress[malondialdehyde(MDA),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)],and micro-inflammatory status[interleukin-6(IL-6),interleukin-17(IL-17),interferon-γ(IFN-γ)]before and after treatment,and occurrence of adverse reactions during treatment between the two groups were compared.Results The total response rate of treatment was significantly higher in the observation group than the control group(85.88%vs 63.53%,P<0.05).After treatment,levels of Scr,BUN,and UA in the observation group were(143.49±25.63)μmol/L,(10.34±1.52)mmol/L,and(386.17±54.52)μmol/L,significantly lower than(174.37±29.48)μmol/L,(12.41±1.83)mmol/L,(415.46±63.81)μmol/L in the control group,while Ccr level in the observation group was(48.51±10.58)mL/min,significantly higher than(42.35±9.26)mL/min in the control group(P<0.05).After treatment,MDA level in observation group was(4.32±0.74)mmol/L,significantly lower than(4.87±0.82)mmol/L in the control group,while levels of SOD and GSH-Px in the observation group were(86.45±1.82)IU/mL and(248.32±6.64)IU/mL,significantly higher than(79.51±1.54)IU/mL,(221.52±8.13)IU/mL in the control group(P<0.05).After treatment,levels of IL-6,IL-7 and IFN-γin the observation group were(130.25±24.13)ng/L,(38.19±8.25)ng/L,and(21.36±3.49)ng/L,significantly lower than(182.57±28.49)ng/L,(77.42±14.57)ng/L,(27.18±5.22)ng/L in the control group(P<0.05).There were no significant adverse reactions in either group during treatment.Conclusion Yiqi Huoxue Recipe combined with western medicine can effectively improve kidney function and oxidative stress status,and reduce inflammation level in CKD patients,with good clinical curative effect.