[1]周 林,禹 红,刘毓玲,等.活肾通络方联合依那普利对慢性肾脏病患者纤维化标志物、人附睾蛋白4水平的影响[J].陕西中医,2023,(10):1400-1403.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.014]
　ZHOU Lin,YU Hong,LIU Yuling,et al.Effect of Huoshen Tongluo decoction and enalapril on renal function,fibrosis markers and HE4 levels in patients with chronic renal disease[J].,2023,(10):1400-1403.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.014]
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活肾通络方联合依那普利对慢性肾脏病患者纤维化标志物、人附睾蛋白4水平的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年10期
页码:
1400-1403
栏目:
临床研究
出版日期:
2023-10-05

文章信息/Info

Title:
Effect of Huoshen Tongluo decoction and enalapril on renal function,fibrosis markers and HE4 levels in patients with chronic renal disease
作者:
周 林1; 禹 红1; 刘毓玲1; 肖桂香2
(1.武汉市中医医院,湖北 武汉 430050; 2.华中科技大学同济医学院附属协和医院,湖北 武汉 430022)
Author(s):
ZHOU Lin; YU Hong; LIU Yuling; XIAO Guixiang
(Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430050,China)
关键词:
慢性肾脏病;  肾功能;  活肾通络方;  纤维化;  人附睾蛋白4
Keywords:
Chronic kidney disease;  Renal function;  Huoshen Tongluo decoction;  Fibrosis;  Human epididymal protein 4
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7369.2023.10.014
文献标志码:
A
摘要:
目的:研究活肾通络方联合依那普利对2～4期慢性肾脏病(CKD)患者肾功能、纤维化标志物、人附睾蛋白4(HE4)水平的影响。方法:采用随机对照研究将78例2～4期CKD患者随机分为两组,各39例。对照组予依那普利,观察组予活肾通络方联合依那普利。两组治疗12周。疗程结束后比较两组疗效、主症和次症积分、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(C-Ⅳ)、层粘连蛋白(LN)、尿素(UR)、肌酐清除率(Ccr)、血肌酐(Scr)、β2-微球蛋白(β2-MG)、HE4、高敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平、中医症候积分。结果: 治疗后观察组总有效率92.31%高于对照组的74.36%(P<0.05); 两组治疗前主症和次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Ccr、Scr、β2-MG、HE4、hs-CRP、IL-6水平比较,差异无统计学意义(P>0.05); 两组主症、次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Scr、β2-MG、HE4、hs-CRP、IL-6水平下降,Ccr水平增加,观察组主症、次症积分、HA、PC-Ⅲ、C-Ⅳ、LN、UR、Scr、β2-MG、HE4水平低于对照组,Ccr水平高于对照组(P<0.05)。结论: 活肾通络方联合依那普利可显著延缓2～4期CKD患者肾纤维化进程,保护肾功能,降低HE4水平。
Abstract:
Objective:To study the effects of Huoshen Tongluo decoction combined with enalapril on renal function,fibrosis markers,and human epididymal protein 4(HE4)levels in patients with 2-4 chronic kidney disease(CKD).Methods:78 patients with stage 2-4 CKD were randomly divided into two groups,39 cases in each group.The control group was given enalapril,and the observation group was given Huoshen Tongluo decoction combined with enalapril.At the end of the treatment course,the efficacy,main and secondary symptom scores,hyaluronic acid(HA),procollagen Ⅲ(PC-Ⅲ),collagen Ⅳ(C-Ⅳ),laminin(LN),urea nitrogen(UR),creatinine clearance rate(Ccr),serum creatinine(Scr),β2-microglobulin(β2-MG),HE4,high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)levels were compared.Results:After treatment the effective rate of the observation group 92.31% was significantly higher than the control group 74.36%(P<0.05).Before treatment,the main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Ccr,Scr,β2-MG,HE4,hs-CRP and IL-6 had no significant difference between two groups(P>0.05); the main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Scr,β2-MG,HE4,hs-CRP and IL-6 were decreased in two groups,and the level of Ccr was increased.The main and secondary symptom scores,levels of HA,PC-Ⅲ,C-Ⅳ,LN,UR,Scr,β2-MG,HE4,hs-CRP and IL-6 were lower than those in the control group,and the levels of Ccr was higher than that in the control group(P<0.05).Conclusion:Huoshen Tongluo decoction combined with enalapril can significantly delay the progression of renal fibrosis,protect renal function,and reduce the level of HE4 in patients with 2-4 stage CKD.

参考文献/References:

[1] 张 鹏,王小勇.百令胶囊对慢性肾脏病3、4期患者营养不良状况及肾功能的影响[J].陕西中医,2021,42(1):54-56.
[2] 王海燕.肾脏病学[M].北京:人民卫生出版社,2012:1815-1816.
[3] 陈灏珠,林果为.实用内科学[M].北京:人民卫生出版社,2012:2187.
[4] 国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:163-168.
[5] 杨 雄,高 伟,邱万胜,等.白蛋白球蛋白比值对慢性肾脏病患者预后判断的价值研究[J].陕西医学杂志,2020,49(6):728-731.
[6] 麦芳雄,张香兰,朱德礼.温肾健脾清化汤辅助治疗脾肾气虚型慢性肾脏病疗效及对患者血清转化生长因子β-1、纤维连接蛋白水平的影响[J].陕西中医,2022,43(8):1068-1071.
[7] 陈 杰,郑 颖,刘文瑞,等.肾衰乙方治疗脾肾亏虚、浊毒瘀阻型慢性肾功能不全临床疗效及炎症机制研究[J].辽宁中医药大学学报,2016,18(9):114-116.
[8] 朱 俊,罗 实,王 钢,等.运用邹云翔教授黄蛭益肾方治疗慢性肾脏病2～4期气阴两虚证的研究[J].中国中西医结合肾病杂志,2022,23(1):82-83.
[9] 张 桥,陈艳琰,乐世俊,等.大黄炮制的历史沿革及对化学成分、传统药理作用影响的研究进展[J].中国中药杂志,2021,46(3):539-551.
[10] 向 璐,张巧艳,赵琦明,等.黄芪-当归化学成分、药理作用及临床应用的研究进展[J].中草药,2022,53(7):2196-2213.
[11] 贾 静,单士刚,迟 恒.丹参酮ⅡA药理作用的研究进展[J].湖北科技学院学报:医学版,2022,36(5):441-444.
[12] 魏 巍,王冰瑶.莪术及其主要成分的药理作用研究进展[J].药物评价研究,2022,45(10):2154-2160.
[13] 刘 璇,高美风,孔 毅.水蛭化学成分及药理作用的研究进展[J].药物生物技术,2017,24(1):76-80.
[14] 王爱华,周 强,王德光,等.人附睾蛋白4在女性慢性肾脏病中的表达及临床价值[J].安徽医学,2022,43(6):625-628.
[15] 胡新民,徐成兴,乔春萍,等.补肾活血方颗粒对慢性肾功能不全患者血清PC-Ⅲ、Col-Ⅳ、LN、FN及肾功能的影响[J].广西中医药,2021,44(2):1-4.
[16] 万国平.桃核承气汤加减联合复方α-酮酸片对慢性肾衰竭患者肾功能及尿TGF-β1、Ⅳ-C水平的影响[J].全科口腔医学电子杂志,2019,6(33):141-142.
[17] 卫德强.中药保守治疗对肾功能不全患者血清Hcy、IL-6及LN的影响[J].中国中医急症,2011,20(10):1697-1699.
[18] 权浩浩,程小红,杜 霞,等.基于整合药理学探讨肾复康Ⅱ号胶囊治疗肾间质纤维化作用机制[J].陕西中医,2020,41(12):1822-1826.
[19] 刘晓华,孙 赞.慢性肾功能衰竭患者血清Hcy、SF和PTH联合检测的临床价值[J].陕西医学杂志,2017,46(9):1310-1312.
[20] 吕艳文,杨 力,张 玫,等.妇科良性疾病并慢性肾功能不全患者人附睾蛋白4水平变化及意义[J].中华实用诊断与治疗杂志,2015,29(4):415-416.
[21] 张 蓉,陈 娟,慕 莹,等.人附睾蛋白4在妇科疾病伴肾功能损害患者诊疗中的应用[J].中国卫生检验杂志,2017,27(14):2044-2046.
[22] 许丹阳.祛风固肾汤对慢性肾脏病患者肾功能及血清IL-6、hs-CRP、TNF-α水平的影响[J].航空航天医学杂志,2022,33(5):592-594.
[23] 沈文清,邢艳芳,钱 捷,等.益肾化湿颗粒对慢性肾脏病患者微炎症和氧化应激状态的影响[J].中国中西医结合肾病杂志,2014,15(12):1097-1099.

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备注/Memo

备注/Memo:
基金项目:湖北省中医药管理局中医药科研项目(ZY2023F052); 武汉市卫生健康委员会医学科研项目(WZ22C69,WZ19C37)
更新日期/Last Update: 2023-10-09