清补地龟汤对肾虚血瘀证IgA肾病肾脏纤维化的影响

Effect of Qingbu Digui Tang on Renal Fibrosis of IgA Nephropathy with Kidney Deficiency and Blood Stasis Syndrome

目的:观察清补地龟汤对肾虚血瘀证IgA肾病肾脏纤维化的影响。方法:将肾虚血瘀证IgA肾病患者64例随机分为对照组和观察组各32例,对照组予常规西药治疗,观察组在对照肾治疗的基础上加服清补地龟汤,2组疗程均为8周;检测2组治疗前后24h尿蛋白定量(24h U-pro)、尿中红细胞、尿素氮(BUN)及肌酐(SCr含量),并计算生肌酐清除率(CCr);ELISA法检测血清Ⅲ型前胶原N端肽P (PⅢNP)、透明质酸酶(HA)、胶原Ⅳ(Col-Ⅳ)、层粘连蛋白(LN)、血管内皮生长因子(VEGF)、转化生长因子-β1 (TGF-β1)、巨噬细胞移动抑制因子(MIF)的含量。结果:治疗后2组患者尿中红细胞、24h U-pro含量较治疗前降低,且观察组优于对照组,差异均有统计学意义(P <0.05);治疗后2组患者血清PⅢNP、HA、Col-Ⅳ、LN含量较治疗前降低,且观察组优于对照组,差异均有统计学意义(P <0.05);治疗后观察组血清MCP-1、TGF-β1、MIF、MMP-9及TIMP-1含量较治疗前、对照组显著降低,VEGF含量较治疗前、对照组显著升高,差异均有统计学意义(P <0.05)。结论:清补地龟汤对IgA肾病患者临床效果显著,对肾脏纤维化具有保护作用。

Objective:To observe the effect of Qingbu Digui tang on renal fibrosis of IgA nephropathy with kidney deficiency and blood stasis syndrome. Methods:A total of 64 cases of patients with IgA nephropathy with kidney deficiency and blood stasis syndrome were randomly divided into the control group and the observation group,32 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Qingbu Digui tang based on the treatment of the control group. Both groups were treated for 8 weeks. Twenty-four-hour urinary protein(24 h U-pro) and the content of erythrocytes,blood urea nitrogen(BUN) and serum creatinine(SCr) in the urine before and after treatment in both groups were detected,and the creatinine clearance rate(CCr) were calculated. The contents of serum procollagen type Ⅲ N-terminal peptide P(PⅢNP),hyaluronic acid(HA),collagenⅣ(Col-Ⅳ),laminin(LN),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1) and macrophage migration inhibitory factor(MIF)were detected by enzyme-linked immunosorbent assay method(ELISA). Results: After treatment, the contents of erythrocytes in the urine and 24 h U-pro in the two groups were lower than those before treatment,and those in the observation group were better than those in the control group,differences being significant(P < 0.05). After treatment,the contents of serum PⅢNP,HA,Col-Ⅳ and LN in the two groups were decreased when compared with those before treatment,and those in the observation group were better than those in the control group,differences being significant(P <0.05). After treatment,the contents of serum MCP-1,TGF-β1,MIF,MMP-9 and TIMP-1 in the observation group were obviously lower than those before treatment and those in the control group,and the content of VEGF in the observation group was obviously higher than that before treatment and that in the control group,differences being significant(P < 0.05).Conclusion:Qingbu Digui tang has a significant clinical effect in treating IgA nephropathy,which can protect renal fibrosis.