小柴胡汤加减改善慢性肾小球肾炎患者炎症及减轻蛋白尿的作用及可行性分析

Effect and feasibility analysis of modified Xiaochaihu decoction on improving inflammation and alleviating proteinuria in patients with chronic glomerulonephritis

目的:分析小柴胡汤加减改善慢性肾小球肾炎患者炎症及减轻蛋白尿的作用及可行性。方法:本次研究中的观察对象均抽选于山东省聊城市阳谷县中医院院接收的慢性肾小球肾炎患者,70例患者的入院时间均在2019年4月-2020年6月。采用简单随机分组法将上述患者分为对照组和观察组,每组各占35例。为对照组患者开展常规西医治疗,观察组患者则联合小柴胡汤加减治疗。比较两组患者的炎症因子水平、24 h尿蛋白定量、肾功能和中医证候积分改善情况。结果:治疗前,观察组患者的人干扰素-γ(Interforon,IFN-γ)、白细胞介素-4(Interleukin,IL-4)、IL-17相比,P>0.05;治疗后,观察组患者的IFN-γ为(19.95±2.04)pg/mL,IL-17为(30.69±2.26)pg/mL,明显低于对照组(28.83±3.12)pg/mL、(76.18±4.41)pg/mL,其IL-4为(41.73±5.69)pg/mL明显高于对照组(30.07±4.19)pg/mL,经检验,t=14.09、9.76、54.31,P<0.05;治疗前,两组患者的24 h尿蛋白定量相比,P>0.05;治疗后,观察组患者的24 h尿蛋白定量为(1.21±0.46)g/,明显低于对照组(1.84±0.59)g/,经检验,t=4.98,P<0.05;治疗后观察组患者的血尿素氮(Blood Urea Nitrogen,BUN)为(7.57±2.01)mmol/L,血肌酐(SCr)为(118.62±12.28)μmol/L,肾小球滤过率(Glomerular Filtration Rate,GFR)为(69.79±6.01)mL/min/1.73 m^(2),同对照组相比,差异不具有统计学意义,经检验,t=0.25、0.04、0.13,P>0.05;治疗后,观察组患者的中医证候积分为(7.75±0.84)分,明显低于对照组(13.38±1.62)分,经检验,t=18.25,P<0.05。结论:小柴胡汤加减治疗慢性肾小球肾炎在改善炎症和缓解蛋白尿方面有积极作用,具有进一步推广实施的价值。

Objective:To analyze the effect and feasibility of modified Xiaochaihu decoction(小柴胡汤)on improving inflammation and alleviating proteinuria in patients with chronic glomerulonephritis.Methods:The subjects in this study were selected from patients with chronic glomerulonephritis admitted to Liaocheng Yanggu County Hospital of Traditional Chinese Medicine,and all 70 patients were admitted from April 2019 to June 2020.The above patients were divided into the control group and the observation group by simple random grouping method,with 35 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with modified Xiaochaihu decoction.The levels of inflammatory factors,24 h urinary protein,renal function and traditonal Chinese medicine(TCM)syndrome scores were compared between the two groups.Results:Before treatment,the comparison of human interferon-γ(IFN-γ),interleukin-4(IL-4)and interleukin-17(IL-17)in two groups showed P>0.05;After treatment,the levels of IFN-γand IL-17 in the observation group were(19.95±2.04)pg/ml and(30.69±2.26)pg/ml,which were significantly lower than those in the control group,(28.83±3.12)pg/ml and(76.18±4.41)pg/ml.The level of IL-4 of the observation group was(41.73±5.69)pg/ml,which was significantly higher than that of the control group,(30.07±4.19)pg/ml,t=14.09,9.76,54.31,P<0.05;Before treatment,24 h urinary protein quantitative comparison between two groups showed P>0.05;After treatment,24 h urinary protein of the observation group was(1.21±0.46)g/24 h,which was significantly lower than that of the control group,(1.84±0.59)g/24 h,t=4.98,P<0.05;After treatment,blood urea nitrogen(BUN)was(7.57±2.01)mmol/L,blood creatinine(SCr)was(118.62±12.28)μmol/L,glomerular filtration rate(GFR)was(69.79±6.01)ml/min/1.73 m^(2) in the observation group,compared with that of the control group,there was no significant difference.By test,t=0.25,0.04,0.13,P>0.05;After treatment,the TCM syndrome score of the observation group was(7.75±0.84)points,which was significantly lower than that of the control group(13.38±1.62)points,t=18.25,P<0.05.Conclusion:In the treatment of chronic glomerulonephritis,modified Xiaochaihu decoction has a positive effect on improving inflammation and alleviating proteinuria,it has the value of further promotion and implementation.