摘要
目的观察清肾颗粒对慢性肾衰竭湿热证患者免疫功能的影响,探讨其作用机制。方法将162例患者按随机数字表法分为试验组和对照组,每组81例,两组均采用西医基础治疗,试验组加服清肾颗粒,每次1袋(10g),每日3次口服,疗程均为12周。观察两组临床疗效,并采用流式细胞仪检测外周血CD4^+T细胞、CD8^+T细胞、Th17细胞含量和核因子-κB p65(nuclear factor-κB p65,NF-κB p65)的活性;采用酶联免疫吸附法(ELISA法)检测血清IL-17、肿瘤坏死因子受体相关因子6(tumor necrosis factor receptor-associated factor 6,TRAF6)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶抑制物-1(matrix metalloproteinase inhibitor-1,TIMP-1)、Ⅳ型胶原(Ⅳcollagen,Col-Ⅳ)表达。结果最后完成156例(试验组77例,对照组79例);试验组临床疾病总有效率为80.52%(62/77),优于对照组的68.35%(54/79),差异有统计学意义(χ~2=54.849,P<0.05);与本组治疗前比较,治疗后试验组CD4^+/CD8^+T细胞比值、Th17细胞含量、NF-κB p65活性及血清IL-17、TRAF6、TIMP-1、TIMP-1/MMP-9比值、Col-Ⅳ水平均降低(P<0.05),对照组MMP-9水平降低(P<0.05),TIMP-1/MMP-9比值升高(P<0.05);与对照组治疗后比较,试验组CD4^+/CD8^+T细胞比值、Th17细胞含量和NF-κB p65活性降低更明显(P<0.05),试验组血清IL-17、TRAF6、TIMP-1、TIMP-1/MMP-9比值、Col-Ⅳ水平降低(P<0.05),MMP-9水平升高(P<0.05)。结论清肾颗粒能够调节慢性肾衰竭湿热证患者机体的免疫功能紊乱及其介导的炎症反应,减轻肾脏纤维化进程。
Objective To observe the effect of Qingshen Granule（QG）on the immune function of chronic renal failure（CRF）patients with damp-heat syndrome（DHS）.Methods A total of 162 CRF patients were assigned to the treated group and the control group by random digit table,81 in each group.All patients were treated with conventional Western medical therapy.Those in the treated group additionally took QG,one package each time（10 g）,thrice per day.The therapeutic course for all was 12 weeks.The clinical efficacy was observed in the two groups.The contents of peripheral blood CD4＋T cells,CD8＋T cells,Th17 cells,and nuclear factor-κB p65（NF-κBp65）activity were detected using flow cytometry.Expressions of serum IL-17,tumor necrosis factor receptor-associated factor 6（TRAF6）,matrix metalloproteinase-9（MMP-9）,matrix metalloproteinase inhibitor-1（TIMP-1）,collagen Ⅳ（Col-Ⅳ）were detected using ELISA.Results Finally 156 patients completed the trial（77cases in the treated group and79 cases in the control group）.The total clinical curative effective rate was significantly higher in the treated group（80.52%,62/77）than in the control group（68.35%,54/79）with statistical differences between the two groups（χ2=54.849,P〈0.05）.Compared with before treatment in the same group,the levels of peripheral blood CD4＋/CD8＋,Th17 cell content,NF-κB p65 activity,serum levels of IL-17,TRAF6,and TIMP-1,TIMP-1/MMP-9ratio,Col-Ⅳlevel all decreased in the treated group after treatment（P〈0.05）;serum MMP-9level decreased（P〈0.05）and TIMP-1/MMP-9ratio increased（P〈0.05）in the control group.Compared with the control group,CD4＋/CD8＋T cell ratio,Th17 cell content,NF-κB p65 activity decreased more obviously in the treated group after treatment（P〈0.05）.Serum levels of IL-17,TRAF6,TIMP-1,TIMP-1/MMP-9ratio,and Col-Ⅳ all decreased（P〈0.05）and MMP-9level increased（P〈0.05）in the treated group（P〈0.05）.Conclusion QG could adjust immune dysfunction and disarranged immunity mediated inflammatory response,and attenuate renal fibrosis in CKD patients with DHS.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2016年第12期1425-1429,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
安徽省科技攻关计划项目(No.12010402117)
国家自然科学基金资助项目(No.81473673
No.81403372)
安徽省自然科学基金项目(No.1508085MH198
No.1308085QH143)
安徽省高校省级自然科学研究项目(No.KJ2012Z221)
关键词
慢性肾衰竭
湿热证
清肾颗粒
免疫炎症机制
chronic renal failure
damp-heat syndrome
Qingshen Granule
immune inflammation mechanism
