摘要
目的:观察加味防己黄芪汤对原发性肾病综合征(PNS)患者的临床疗效,分析其微炎状态水平,并探索其对血管生成素样蛋白3(ANGPTL3)的影响。方法:选取2016年6月至2017年6月广安市人民医院收治的PNS患者90例,随机分成对照组和观察组,各45例。2组患者均接受西医关于PNS的基础治疗:PNS教育、PNS饮食,以及抗凝、抗感染、利尿、激素等治疗,观察组在此基础上加用加味防己黄芪汤,2组均以6周为1个疗程,3个疗程后观察疗效、蛋白尿排泄率和各炎性反应指标。结果:2组临床总有效率比较,观察组优于对照组,差异有统计学意义(P<0.05)。)治疗后2组患者UAER均较治疗前改善,观察组改善更为明显(P<0.05)。2组患者治疗前,检测的血清IL-1β、IL-6、IL-10及TNF-α比较,差异无统计学意义(P>0.05),而2组治疗后比较,观察组明显低于对照组(P<0.05)。与对照组比较,治疗后观察组患者血ANGPTL3平均值较高(P<0.05),而尿ANGPTL3/Cr差异无统计学意义(P>0.05)。结论:加味防己黄芪汤可有效治疗PNS,其治疗机制可能与降低炎性反应水平有关,此外,血ANGPTL3水平可能是反映PNS患者激素药物治疗后蛋白尿转归的重要指标。
Objective： To observe the clinical efficacy of Jiawei Fangji Huangqi Decoction on primary nephrotic syndrome（ PNS）patients,and to analyze the level of microinflammatory state and explore its effect on Angiopoietin-like Protein 3（ ANGPTL3）.Methods： A total of 90 cases of PNS patients admitted to our hospital from June 2016 to June 2017 were randomly divided into control group and observation group. The two groups were treated with western medicine of the basic treatment of PNS,including PNS education,PNS diet,anticoagulation,anti-infection,diuretic,hormones and other treatment,while the observation group was added modified Jiawei Fangji Huangqi Decoction on the basis of that. Both groups were treated for 6 weeks as a treatment course.The efficacy,proteinuria excretion rate and the level of inflammation indicators were observed after 3 treatment courses. Results：1） The total effective rate of the two groups was statistically significant（ P 〈0. 05）,and the observation group was superior to the control group. 2） After treatment,the u AER of the two groups was improved compared with that before treatment and the improvement rate of the observation group was more significant（ P 〈0. 05）. There was no significant difference in serum IL-1β,IL-6,IL-10 and TNF-α between the two groups before treatment. Compared between groups after treatment,the observation group was significantly lower than that of control group（ P 〈0. 05）. 4） Compared with the control group,the average concentration of ANGPTL3 in the observation group was higher（ P〈 0. 05）,but there was no significant difference in ANGPTL3/Cr concentration between the two groups（ P 〉0. 05）. Conclusion： Jiawei Fangjiu Huangqi Decoction can effectively treat PNS. The therapeutic mechanism may be related to the decrease of inflammation level. In addition,the level of ANGPTL3 may be an important index to reflect the prognosis of proteinuria PNS patients after hormone treatment.
作者
毛仁丽
陈丽
秦盼盼
Mao Renli;Chen Li;Qin Panpan(Department of Nephrology, Guang＇an People＇s Hospital, Guang＇an 638000, Chin)
出处
《世界中医药》
CAS
2018年第3期624-627,631,共5页
World Chinese Medicine
基金
四川省卫生厅科研课题(17PJ090)
关键词
加味防己黄芪汤
原发性肾病综合征
临床疗效
肾功能
微炎状态
炎性因子
血管生成素样蛋白3
机制
Modified Fangji Huangqi Decoction
Primary nephrotic syndrome
Clinical effect
Renal function
Microinflammatory state
Inflammatory factor
Angiopoietin-like Protein 3
Mechanism
