摘要
目的:观察右归丸对激素抵抗型肾病综合征(SRNS)脾肾阳虚型患者的增敏作用及其机制。方法:将40例SRNS患者随机分为对照组和治疗组,对照组20例,治疗组20例,对照组采用常规西医治疗,治疗组在西医常规治疗的基础上加右归丸。分别观察两组患者治疗1月后、治疗2月后的水肿消退时间、尿蛋白转阴时间、中医症状总积分并检测外周静脉血液中单个核细胞(PBMC)MDR1、P-gp170以及GRα、GRβ的变化。结果:(1)经治疗2月后,治疗组临床疗效总有效率为100.00%,对照组则为60.00%,差异有统计学意义(P<0.05)。(2)治疗后,治疗组的水肿消退时间、尿蛋白转阴时间、中医症状总积分,与对照组相比较,差异均有统计学意义(P<0.05)。(3)耐药基因方面:经治疗后,治疗组外周静脉血液中PBMC MDR1、P-gp170的表达量减少,而GRα的表达量增加,GRβ的表达量无明显改变。MDR1、P-gp170及GRα治疗组与治疗前、同期对照组相比较差异有统计学意义(P<0.05);而GRβ表达量两组前后变化差值比较差异无统计学意义(P>0.05)。结论:右归丸对SRNS有一定的增敏作用,其机制可能与降低PBMC MDR1、P-gp170的表达及上调GRα表达量有关。
Objective：To observe the effect and mechanism of Yougui Pill’s sensibilization in steroid resistant nephritic syndrome（ SRNS）patients,which the patients belong to PiShenYangXu type according to the treatment based on syndrome differentia-tion. Methods：To select 40 yangxu tape SRNS patients,which were divided into two groups,the number of Control Group is 20,and the treatment group is 20. The control group used Glucocorticoid（ GC）and Western medicine conventional therapy,the treatment group used Yougui Pill on the basis of the control group medication. Drawing their peripheral venous blood in 1 month,2 month after treatment at 2 time points,to detect the expression of MDR1、P-gp170 and GRα、GRβin blood mononuclear cells（ PBMC）,and re-cord their clinical symptoms and signs of traditional Chinese medicine,the change of urine protein in the urine routine at the same time. Results：（1）After 2 months’treatment,the total effect rate of the treatment group is 100%,meanwhile,the control group is 60%（P〈0. 05）.（2）After treatment,compared with the control group,the time of edema extinction,proteinuria turn to negative and the score of T. C. M syndrome is much more better than the control group.（3）Resistance Genes：After treatment,the expression of PBMC MDR1、P-gp170 in treatment group is dereased（P〈0. 05）. However,the expression of PBMC GRα is increased（P〈0. 05）,meanwhile,the expression of PBMC GRβhas little change after treatment（P〉0. 05）. Conclusion：Yougui Pill has a positive effect on SRNS patients,the mechanism may be related to the decrease of PBMC MDR1、P-gp170 and the increase of the GRα.
出处
《中国中西医结合肾病杂志》
2014年第12期1052-1055,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
甘肃省科技计划项目(B类计划)(No.1212RT2A076)
