越婢汤加味对慢性肾功能衰竭患者NF-κB信号通路的影响

Effect of Modified Yuebi Decoction on NF-κB Signal Path of Patients with Chronic Renal Failure

目的:探讨NF-κB信号通路介导的炎症反应对慢性肾功能衰竭脾肾阳虚、瘀水内停患者的影响及越婢汤加味的干预作用。方法:选取慢性肾功能衰竭患者60例,采用随机数字表法分为对照组和观察组。对照组采用西医常规治疗,观察组在对照组的基础上加用越婢汤加味,疗程为3个月。观察两组患者临床有效率,中医证候积分、肾功能、炎症因子及磷酸化细胞核因子NF-κB p65(nuclear factor kappa-B p65,NF-κB p65)、纤维连接蛋白(fibronectin,FN)、单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)水平变化。结果:两组患者治疗前中医证候评分、肾功能及炎症因子及NF-κB p65、FN、MCP-1指标比较,差异无明显统计学意义(P>0.05)。治疗后,观察组的临床有效率为90.00%,明显高于对照组56.67%,差异有统计学意义(P<0.05);两组患者中医证候评分均较治疗前显著改善(P<0.05),且观察组较对照组更为明显(P<0.05);两组患者治疗后肾功能(肌酐、尿素氮、24小时尿蛋白)均较治疗前显著降低(P<0.05),血清肌酐清除率较治疗前显著升高(P<0.05),且观察组优于对照组(P<0.05);两组患者治疗后炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(hypersensitive C reactive protein,hs-CRP]及NF-κB p65、MCP-1、FN均较治疗前明显降低(P<0.05),且观察组优于对照组(P<0.05)。结论:越婢汤加味可明显改善慢性肾功能衰竭患者的临床症状及体征,改善肾功能,其机制可能与抑制NF-κB信号通路活化,下调MCP-1、FN有关。

Objective:To explore NF-κB The effect of inflammatory reaction mediated by NF-κB signal pathway on the patients with chronic renal failure with Spleen and Kidney Yang deficiency as well as blood stasis and water stagnation,and the intervention of modified Yuebi Decoction on it.Methods:60 patients with chronic renal failure were randomly divided into control group and observation group.The control group was treated with conventional western medicine,while the observation group was treated with modified Yuebi Decoction on the basis of the control group.The course of treatment was 3 months.Observe the total clinical effective rate,TCM syndrome score,renal function,inflammatory factors and phosphorylated nuclear factor NF of the two groups-κB p65(NF-κB p65),fibronectin(FN),monocyte chemotactic protein 1(MCP-1).Results:TCM syndrome score,renal function,inflammatory factors and NF of the two groups of patients before treatment-κThere was no significant difference in B p65,FN and MCP-1(P>0.05).After treatment,the clinical effective rate of the observation group was 90.00%,which was significantly higher than that of the control group(56.67%,P<0.05);The TCM syndrome scores of the two groups were improved compared with those before treatment(P<0.05),and the observation group was significantly better than the control group(P<0.05);After treatment,the renal function(creatinine,urea nitrogen,24-hour urine protein)of the two groups was lower than that before treatment(P<0.05),and the serum creatinine clearance rate was higher than that before treatment(P<0.05),and the observation group was superior to the control group(P<0.05);Inflammatory factors[tumor necrosis factor]after treatment in both groups-α(TNF-α),Interleukin-6(IL-6),C-reactive protein(hs CRP)and NF-κB p65,MCP-1,FN were significantly lower than those before treatment(P<0.05),and the observation group was better than that off the control group(P<0.05).Conclusion:The modified Yuebi Decoction can significantly improve the clinical symptoms and signs of patients with chronic renal failure,and improve renal function.Its mechanism may be related to the inhibition of the activation of NF-κB signal pathway and the down-regulation of MCP-1 and FN.