摘要
目的:评价肾衰方改善早中期慢性肾衰竭患者肾功能及纤维化的临床疗效,并探讨其作用机制。方法:选取慢性肾脏病3,4期(脾肾气虚、瘀血阻滞型)患者60例,随机分为对照组和治疗组,前者在西医一体化治疗基础上给予氯沙坦钾,后者在前者的基础上加用肾衰方,治疗6个月后,观察两组患者中医证候积分、中医证候疗效、疾病疗效、血红蛋白、肾功能、24 h尿蛋白定量、结缔组织生长因子(CTGF)、骨形态发生蛋白-7(BMP-7)的变化。结果:治疗后,治疗组中医证候疗效、疾病疗效明显优于对照组(P<0.01),治疗组在降低24 h尿蛋白定量,降低肌酐,提高肾小球滤过率方面优于对照组(P<0.05,P<0.01)。两组慢性肾衰竭患者血清CTGF水平均明显降低(P<0.05),BMP-7水平明显升高(P<0.05)。结论:肾衰方治疗早中期慢性肾衰竭患者较对照组有明显的临床疗效,能减少蛋白尿、改善肾功能、防治肾脏纤维化,其作用机制可能与其下调血清CTGF以及上调BMP-7的表达有关。
Objective： To evaluate the clinical effect of renal failure recipe on renal function and fibrosis in patients with early and middle-term chronic renal failure. Method： Totally 60 cases of patients with three and four-stage chronic kidney disease（ spleen and kidney deficiency,blood stasis type） were selected and randomly divided into control group and treatment group. The former received losartan in addition to western medicine integration treatment,while the latter was given renal failure recipe in addition to the former＇s therapy. After 6months of treatment,we observed the changes in traditional Chinese medicine（ TCM） syndrome scores and curative effect,therapeutic efficacy,hemoglobin,renal function,24-hour urine protein,connective tissue growth factor（ CTGF） and bone morphogenetic protein-7（ BMP-7） in the two groups of patients. Result： The curative effect of TCM syndrome and curative effect of treatment group were obviously superior to that of control group（ P 〈0. 01）.Treatment group was superior to control group in reduction in 24-hour urine protein and creatinine and increase in glomerular filtration rate（ P 〈0. 05,P 〈0. 01）. The two groups showed significant reduction in serum CTGF levels（ P 〈0. 05）,and increase in blood bone morphogenetic protein-7（ BMP-7） level（ P 〈0. 05）. Conclusion： Renal failure recipe shows an obvious clinical curative effect in treating patients with early and middle-term chronic renal failure compared with the control group,and can reduce proteinuria,alleviate renal function,and prevent renal fibrosis. Its mechanism may be related to the down-regulation of serum CTGF and upregulation of BMP-7expression.
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2016年第15期166-170,共5页
Chinese Journal of Experimental Traditional Medical Formulae
基金
上海浦东新区卫生和计划生育委员会卫生科技资助项目(PW2014B-12)
关键词
肾衰方
慢性肾衰竭
早中期
肾脏纤维化
结缔组织生长因子
骨形态发生蛋白-7
renal failure recipe
chronic renal failure
early and middle term
kidney fibrosis
connective tissue growth factor（CTGF）
bone morphogenetic protein-7（BMP-7）
