肾衰康方对慢性肾衰竭患者氧化应激状态下肾脏保护作用的临床研究

A clinical study on the on renal protection effect of the Shenshuai prescription on chronic renal failure under oxidative stress

目的:研究肾衰康方对慢性肾衰竭患者氧化应激状态下对肾脏的保护作用,明确肾衰康方对慢性肾衰竭患者氧化应激状态下的治疗效果。方法:收集2020年1月-2021年8月于广东祈福医院肾病科住院和门诊就诊的符合慢性肾衰竭西医诊断(133μmol/L≤血肌酐≤707μmol/L),但未进入透析或肾移植阶段,且中医辨证属脾肾虚衰,湿浊(毒)瘀血互结型慢性肾衰竭患者60例,采用分层随机入组法分为肾衰康方治疗组(30例)和对照组(30例),肾衰康方治疗组使用肾衰康方治疗,对照组给予常规治疗,统计分析肾衰康方治疗组及对照组中医症状积分、丙二醛(Malondialdehyde,MDA)、氧化应激[超氧化物歧化酶(Superoxide Dismutase, SOD)、超敏C反应蛋白(Hypersensitive C-reactive Protein,Hs-CRP)、白细胞介素-6(Interleukin,IL-6)、尿素氮(Blood Ure Nitrogen,BUN)、胱抑素-C(Cystatin-C,Cys-C)、β_(2)-微球蛋白、肾小球滤过率(Glomerular Filtration Rate,GFR)、血清白蛋白(Albumin,ALB)、血脂[总胆固醇(Total cholesterol,TC)、三酰甘油(Triglyceride,TG)、低密度脂蛋白(LDL)]、血钙、血磷、血钾、肝功能[谷丙转氨酶(Alanine Aminotransferase,ALT)、谷草转氨酶(Aspartic Transaminase,AST)]。结果:肾衰康方治疗组中医症状积分、MDA、hs-CRP、IL-6、BUN、Cys-C、β_(2)-微球蛋白、GFR、ALB、血脂(TC、TG、LDL)、血钙、血磷、血钾、肝功能(ALT、AST)明显低于对照组,SOD明显高于对照组,P <0.05。结论:慢性肾衰竭患者存在明显的氧化应激反应,通过肾衰康方治疗可有效清除患者体内的氧自由基,提高抗氧化活性,减轻患者的氧化应激状态。

Objective:To study the protective effect of the Shenshuaikang prescription(肾衰康方)on the kidney of patients with chronic renal failure under oxidative stress,and to clarify the therapeutic effect of the Shenshuaikang prescription on patients with chronic renal failure under oxidative stress.Methods:From January 2020 to August 2021,60 patients with chronic renal failure who were diagnosed by Western medicine(133μmol/L≤serum creatinine≤707μmol/L),but did not enter the stage of dialysis or renal transplantation,and whose TCM syndrome differentiation belonged to spleen and kidney deficiency failure,dampness(toxin)and blood stasis type of chronic renal failure were collected.Stratified random inclusion method was used for grouping,and the patients were divided into the treatment group(30 cases)and the control group(30 cases),the treatment group was treated with the Shenshuaikang prescription,and the control group was given conventional treatment.The TCM symptom score,MDA,SOD,hs CRP,IL-6,BUN,Cys-C,β_(2)-microglobulin,GFR,ALB,blood lipid(TC,TG,LDL),blood calcium,blood phosphorus,blood potassium,liver function(ALT,AST)in the treatment group and the control group were statistically analyzed.Results:The TCM symptom score,MDA,hs CRP,IL-6,BUN,Cys-C,β_(2)-microglobulin,GFR,ALB,blood lipid(TC,TG,LDL),blood calcium,blood phosphorus,blood potassium,liver function(ALT,AST)in the treatment group were significantly lower than those in the control group,while SOD in the treatment group was significantly higher than that in the control group,P<0.05.Conclusion:There is obvious oxidative stress reaction in patients with chronic renal failure.The Shenshuaikang prescription can effectively remove oxygen free radicals in patients,improve antioxidant activity,and reduce oxidative stress.