大黄泄浊方治疗慢性肾脏病3b-4期患者的疗效及对脂联素、微炎症状态的影响

Effect of Dahuang Xiezhuo Formula on Patients with Chronic Renal Disease in Stage 3b-4 and Its Influence on Adiponectin and Microinflammatory Status

目的:研究大黄泄浊方治疗慢性肾脏病(CKD)3b-4期患者的疗效及对脂联素、微炎症状态的影响。方法:选取2020年12月至2021年11月我院收治的70例CKD 3b-4期的患者为研究对象,根据治疗方案随机分为接受海昆肾喜胶囊联合常规西医治疗的对照组35例和接受大黄泄浊方联合常规西医治疗的治疗组35例,2组均持续治疗8 w。对比2组治疗前后主要中医证候积分、白蛋白(Alb)、血肌酐(Scr)、肾小球滤过率(eGFR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、脂联素(ADP)、瘦素(Lep)、超敏C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素10(IL-10)水平。结果:与本组治疗前相比,治疗组治疗后中医证候积分、Scr、ADP、Lep、IL-6、CRP、TC、TG、LDL-C水平较前下降(P<0.05),Alb、IL-10、eGFR水平较前上升(P<0.05);对照组治疗后中医证候积分、Scr、ADP、IL-6、CRP、TC、TG、LDL-C水平较前下降(P<0.05),Alb、eGFR水平较前上升(P<0.05),IL-10改变差异无统计学意义(P>0.05)。组间相比,治疗组治疗后中医证候积分、Scr、ADP、IL-6、CRP、TC、TG、LDL-C水平较对照组下降明显(P<0.05),Alb、IL-10、eGFR水平较对照组明显上升(P<0.05)。结论:大黄泄浊方联合常规西医治疗CKD 3b-4期患者,可显著缓解临床症状,降低CRP、IL-6、ADP、Lep水平,提高IL-10血清含量,改善患者的微炎症状态。

Objective:To study the efficacy of Dahuang Xiezhuo Formula in treating patients with chronic kidney disease(CKD)in stage 3b-4 and its influence on adiponectin and microinflammatory state.Methods:70 patients with CKD in stage 3b-4 admitted to our hospital from December 2020 to November 2021 were selected as the study subjects.According to the therapeutic regime,they were randomly divided into a control group of 35 patients receiving Haikun Shenxi Capsule combined with conventional Western medicine treatment and a treatment group of 35 patients receiving Dahuang Xiezhuo Formula combined with conventional Western medicine treatment.Both groups were treated for 8 weeks.Before and after treatment,the main TCM syndrome scores,albumin(Alb),serum creatinine(Scr),glomerular filtration rate(eGFR),total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C),adiponectin(ADP),leptin(Lep),hypersensitive C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-10(IL-10)levels in the two groups were compared.Results:After treatment,the TCM syndrome scores,Scr,ADP,Lep,IL-6,CRP,TC,TG,and LDL-C levels in the treatment group decreased(P<0.05),while the levels of Alb,IL-10,and eGFR increased(P<0.05);the TCM syndrome score,Scr,ADP,IL-6,CRP,TC,TG,LDL-C levels in the control group decreased(P<0.05),while the levels of Alb and eGFR increased(P<0.05).There was no significant difference in the changes of IL-10(P>0.05).Compared with the control group,the TCM syndrome score,Scr,ADP,IL-6,CRP,TC,TG,and LDL-C levels in the treatment group decreased significantly after treatment(P<0.05),while the levels of Alb,IL-10,and eGFR in the treatment group increased significantly(P<0.05).Conclusion:Dahuang Xiezhuo Formula combined with conventional Western medicine can significantly alleviate clinical symptoms,reduce the levels of CRP,IL-6,ADP,Lep,increase the serum level of IL-10,and improve the patients'microinflammatory state in CKD stage 3b-4 patients.