消白冲剂对气虚湿瘀型慢性肾炎患者血液动力学的影响

The Influence of Xiaobai Instant Granules on Blood Rheology in Chronic Nephritis with Qi - Deficiency, Damp and Blood - Stasis Syndrome

目的:观察消白冲剂对气虚湿瘀型慢性肾炎(CGN)患者血液动力学、减少尿蛋白的作用机理。方法:将60例患者随机分为2组。治疗组30例口服消白冲剂(处方:黄芪、石韦、白茅根、益母草、鬼箭羽)治疗,对照组30例口服保肾床治疗。均以3月为1疗程。测定治疗前后血肌酐(Cr)、血尿素氮(BUN、内生肌酐清除率(Ccr)、24h尿蛋白定量等生化指标及血浆内皮素(ET)、降钙素基因相关肽(CGRP)、血栓素(TXB_2)、6-酮-前列腺素(6-keto-PGF_(1α))等血管活性因子的水平。结果:2组对临床主要症状均有改善作用,但治疗组对乏力、纳减等症状的改善优于对照组。2组治疗后均可显著降低24h尿蛋白定量,而且Ccr有上升的趋势(P<0.05)。治疗组ET值较治疗前有所下降(P<0.05),CGRP值较治疗前有所上升(P<0.05);2组TXB_2值较治疗前均有所下降(P<0.05,6-keto-PGF_(1α)值较治疗前有所上升(P<0.05)。结论:消白冲剂能纠正血管活性因子水平,改善肾脏血液动力学,从而有效地降低尿蛋白。

Objective: To observe the mechanism of Xiaobai In- stant Granules(XIG) for improving blood rheology and reducing urine protein in chronic nethritis with qi - dificiency, damp and blood - stasis syndrome. Methods: 60 cases were allocated to treat- ment group and control group randomly. The treatment group was treated by oral use of XIG(composed of Radix Astragali, Folium Pyrrosiae, Rhizoma Imperatae, Herba Leonuri and Herba Buchnerae Cruciatae) and control group by oral use of Baoshenkang. 3 months constituted a course of treatment. SCr, BUN, Ccr, 24h quantitative urinary protein, ET, CGRP, TXB_2 and 6 - keto - PGF_(1α) were deter- mined before and after treatment. Results: The chief symptoms of both groups were improved but the improvement of weakness and anorexia was more marked in the treatment group than the control group. After treatment, the 24h urinary protein was reduced and Ccr was increased in both groups(P < 0.05). ET was (decreased(P < 0.05) and CGRP was increased after treatment(P < 0.05) in the treatment group. TXB_2 was decreased(P < 0.05) and 6 - keto - PCG_(1α) was increased(P < 0.05) after treatment in both groups. Conclusion: XIG can correct the level of vascular active factors and improve the blood rheology of kidney so as to decrease the urinary protein.