益气养阴和络方对气阴两虚兼血瘀证IgA肾病患者疗效及免疫炎症水平的影响

Effect of Yiqi Yangyin Heluo Formula on the efficacy and immune inflammation level of IgA nephropathy patients with syndrome of deficiency of both qi and yin combined with blood stasis

目的探讨益气养阴和络方对气阴两虚兼血瘀证IgA肾病患者疗效及免疫炎症水平的影响。方法选取2021年4月至2022年12月北京市昌平区中西医结合医院肾病科门诊及住院的Ig A肾病患者80例,按照随机数字表法将其分为治疗组与对照组,每组40例。治疗组给予益气养阴和络方颗粒,对照组给予缬沙坦,疗程均为24周。比较两组治疗前后24 h尿蛋白定量、血肌酐、血尿素氮、中医证候积分、临床疗效、Th1细胞比例、Th2细胞比例、Th1/Th2水平及炎症因子水平。结果治疗后,治疗组24 h尿蛋白定量、血肌酐、血尿素氮水平均较治疗前降低,对照组24 h尿蛋白定量较治疗前降低,差异有统计学意义(P<0.05)。治疗后,治疗组24 h尿蛋白定量、血肌酐、血尿素氮水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组中医证候积分较治疗前降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组Th2细胞比例较治疗前降低、Th1/Th2水平较治疗前升高,且治疗组Th2细胞比例低于对照组,Th1/Th2水平高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组血清白细胞介素(IL)-2、IL-4、IL-6水平均低于治疗前,对照组血清IL-4、IL-6水平低于治疗前,差异有统计学意义(P<0.05)。治疗后,治疗组血清IL-2、IL-4、IL-6水平均低于对照组,差异有统计学意义(P<0.05)。结论益气养阴和络方可显著提高Ig A肾病蛋白尿的缓解率,其作用机制可能通过调节Th1/Th2免疫稳态,抑制炎症因子释放,从而降低尿蛋白。

Objective To investigate the effect of Yiqi Yangyin Heluo Formula on the efficacy and immune inflammation level of IgA nephropathy patients with syndrome of deficiency of both qi and yin combined with blood stasis.Methods A total of 80 patients with IgA nephropathy who were outpatients and inpatients in the Department of Nephrology,Beijing Changping Hospital of Traditional Chinese and Western Medicine from April 2021 to December 2022 were selected and they were divided into treatment group and control group according to random number table method,with 40 cases in each group.The treatment group was given Yiqi Yangyin Heluo Formula Granules,and the control group was given Valsartan.The treatment courses were 24 weeks.The 24 h urinary protein quantification,serum creatinine,blood urea nitrogen,traditional Chinese medicine syndrome score,clinical efficacy,Th1 cell proportion,Th2 cell proportion,Th1/Th2 levels,and inflammatory factor level were compared between the two groups before and after treatment.Results After treatment,24 h urinary protein quantification,serum creatinine,and blood urea nitrogen levels in the treatment group were lower than before treatment,and 24 h urinary protein in the control group was lower than before treatment,and the differences were statistically significant(P<0.05).After treatment,24 h urinary protein quantification,serum creatinine,and blood urea nitrogen levels in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the traditional Chinese medicine syndrome score in the treatment group was lower than before treatment,and that in the treatment group was lower than that in the control group,and the differences were statistically significant(P<0.05).The clinical effect of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the proportion of Th2 cells in the treatment group was lower than before treatment,and the Th1/Th2 level in the treatment group was higher than before treatment,and the proportion of Th2 cells in the treatment group was lower than that in the control group,and the Th1/Th2 level in the treatment group was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum interleukin(IL)-2,IL-2,IL-4,IL-6 in the treatment group were lower than before treatment,and the levels of serum IL-4 and IL-6 in the control group were lower than before treatment,and the differences were statistically significant(P<0.05).After treatment,the levels of serum IL-2,IL-4,IL-6 in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Yiqi Yangyin Heluo Formula can significantly improve the remission rate of proteinuria in IgA nephropathy,and its mechanism may be through regulating Th1/Th2 immune homeostasis,inhibiting the release of inflammatory factors,and thereby reducing urinary protein.