黄葵联合保肾康治疗IgA肾病的临床疗效分析

Therapeutic Effect of Huangkui Combined with Baoshenkang on IgA Nephropathy

目的探究黄葵胶囊联合保肾康治疗IgA肾病的临床效果及其可能的作用机制。方法选取2016年1月~2018年1月于昆山市中医医院诊治的IgA肾病患者78例,分为A、B两组,每组各39例。两组均给予西医基础治疗+黄葵胶囊治疗,A组同时服用保肾康治疗。对比两组治疗前后24 h尿蛋白定量、血清白蛋白(ALB)、血清肌酐(Scr)、肾小球滤过率(eGFR)、胱抑素C(CysC)、血清及尿液中的血管内皮细胞生长因子(VEGF)、内皮素-1(ET-1)、单核细胞趋化因子-1(MCP-1)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及临床疗效。结果两组治疗后,A组患者的24 h尿蛋白定量、CysC、血清及尿液中VEGF、ET-1、血清MCP-1、TNF-α、IL-6水平均低于B组(P<0.05),ALB高于B组(P<0.05),A组患者的总体疗效分布情况优于B组(P<0.05),两组的Scr、eGFR差异均无统计学意义(P>0.05)。结论黄葵胶囊联合保肾康治疗IgA肾病能够显著改善VEGF、ET-1、MCP-1、TNF-α、IL-6水平,减轻对肾脏的损伤作用。

Objective To explore the clinical effect and mechanism of huangkui capsule combined with baoshenkang in the treatment of IgA nephropathy.Methods A total of 78 patients with IgA nephropathy admitted to Kunshan Hospital of Traditional Chinese Medicine were divided into group A(39 cases) and group B(39 cases).Both groups were treated with western medicine and huangkui capsule.Group A was additionally treated with baoshenkang.The levels of 24-hour urinary protein, serum albumin(ALB),serum creatinine(Scr),glomerular filtration rate(eGFR),serum cystatin C(CysC),vascular endothelial growth factor(VEGF) in serum and urine, endothelin-1(ET-1) in serum and urine, serum monocyte chemokine-1(MCP-1),serum tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6) and clinical efficacy were compared between the two groups before and after treatment.Results After treatment, the levels of 24-hour urinary protein, CysC,VEGF and ET-1 in serum and urine, MCP-1,TNF-α,IL-6 in group A were lower than those in group B(P<0.05),the level of ALB was higher than that in group B(P<0.05).After treatment, the overall efficacy in group A was better than that in group B(P<0.05).There were no significant differences in the levels of Scr and eGFR between the two groups(P>0.05).Conclusion Huangkui capsule combined with baokangkang might significantly improve the levels of VEGF,ET-1,MCP-1,TNF-α and IL-6,reduce the renal injury in the treatment of IgA nephropathy.