百令胶囊联合羟氯喹治疗原发性IgA肾病的临床研究

Clinical study of Bailing Capsules combined with hydroxychloroquine in treatment of primary IgA nephropathy

目的观察百令胶囊联合羟氯喹治疗原发性IgA肾病的临床疗效。方法选取2019年8月—2021年7月宝鸡市中医医院收治的92例原发性IgA肾病患者,按随机数字表法分为对照组和治疗组,每组各46例。对照组进餐时口服硫酸羟氯喹片,0.2 g/次,2次/d。治疗组在对照组基础上口服百令胶囊,4粒/次,3次/d。两组疗程均为12周。观察两组的临床疗效,比较治疗前后两组主要症状积分、肾功能指标以及血清白细胞介素(IL)-17、IL-23、单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β1(TGF-β1)和基质金属蛋白酶-9(MMP-9)水平。结果治疗后,治疗组总有效率为95.7%,显著高于对照组82.6%(P<0.05)。治疗后两组血尿、泡沫尿、面浮肢肿、腰膝酸软积分均显著降低(P<0.05);且治疗后,治疗组以上各项症状积分均显著低于对照组(P<0.05)。治疗后,两组24 h尿蛋白定量(24 h UP)和血清肌酐(Cr)、尿素氮(BUN)水平均较治疗前显著下降(P<0.05);且均以治疗组的改善更显著(P<0.05)。治疗后两组血清IL-17、IL-23、MCP-1、TGF-β1和MMP-9水平均显著降低(P<0.05);且均以治疗组的下降更显著(P<0.05)。结论百令胶囊联合羟氯喹治疗原发性IgA肾病的整体疗效确切,能有效缓解患者临床症状,保护肾功能,并可进一步下调体内IL-17、IL-23、MCP-1、TGF-β1和MMP-9水平,从而利于减轻患者机体炎性损伤,抑制组织纤维化,且安全性较好。

Objective To observe the clinical efficacy of Bailing Capsules combined with hydroxychloroquine in treatment of primary IgA nephropathy.Methods A total of 92 patients with primary IgA nephropathy admitted to Baoji Hospital of Traditional Chinese Medicine from August 2019 to July 2021 were selected and divided into control group and treatment group according to random number table method,with 46 cases in each group.Patients in the control group were po administered with Hydroxychloroquine Sulfate Tablets with meals,0.2 g/time,twice daily.Patients in the treatment group were po administered with Bailing Capsules on the basis of the control group,4 grains/time,three times daily.Patients in two groups were treated for 12 weeks.After treatment,the clinical efficacy was evaluated,and the main symptom scores,renal function indexes,serum interleukin(IL)-17,IL-23,monocyte chemoattractant protein-1(MCP-1),transforming growth factor-β1(TGF-β1),and matrix metalloproteinase-9(MMP-9)levels were compared between the two groups before and after treatment.Results After treatment,the total effective rate of treatment group was 95.7%,which was significantly higher than that of control group 82.6%(P<0.05).After treatment,the scores of hematuria,foaming urine,floating face and swollen limbs,waist and knee tenderness were significantly decreased(P<0.05).After treatment,the scores of the above symptoms in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,24 h UP,serum Cr and BUN levels in both groups were significantly decreased compared with those before treatment(P<0.05).The improvement was more significant in the treatment group(P<0.05).After treatment,serum levels of IL-17,IL-23,MCP-1,TGF-β1 and MMP-9 were significantly decreased in both groups(P<0.05).The decrease was more significant in the treatment group(P<0.05).Conclusion Bailing Capsules combined with hydroxychloroquine has a definite overall curative effect in treatment of primary IgA nephropathy,and can effectively relieve the clinical symptoms of patients,protect renal function,and further down-regulate IL-17,IL-23,MCP-1,TGF-β1 and MMP-9.Therefore,it is beneficial to reduce the inflammatory injury of the patient,inhibit the tissue fibrosis,and the safety is good.