[1]任剑雄,韦淇元,梁建亮.参芪真武汤加味治疗原发性肾病综合征疗效及对患者肾功能、微炎状态、凝血纤溶功能的影响[J].陕西中医,2024,(8):1052-1055,1060.[doi:DOI:10.3969/j.issn.1000-7369.2024.08.009]
 REN Jianxiong,WEI Qiyuan,LIANG Jianliang.Effect of Shenqi Zhenwu decoction on primary nephrotic syndrome and its influence on renal function,micro-inflammatory state,coagulation and fibrinolytic function[J].,2024,(8):1052-1055,1060.[doi:DOI:10.3969/j.issn.1000-7369.2024.08.009]
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参芪真武汤加味治疗原发性肾病综合征疗效及对患者肾功能、微炎状态、凝血纤溶功能的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1052-1055,1060
栏目:
临床研究
出版日期:
2024-08-05

文章信息/Info

Title:
Effect of Shenqi Zhenwu decoction on primary nephrotic syndrome and its influence on renal function,micro-inflammatory state,coagulation and fibrinolytic function
作者:
任剑雄韦淇元梁建亮
(佛山市中医院,广东 佛山 528000)
Author(s):
REN JianxiongWEI QiyuanLIANG Jianliang
(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)
关键词:
原发性肾病综合征 参芪真武汤 脾肾阳虚证 肾功能 微炎症状态 凝血纤溶功能
Keywords:
Primary nephrotic syndrome Shenqi Zhenwu decoction Spleen and kidney yang deficiency syndrome Renal function Micro-inflammatory state Coagulation and fibrinolytic function
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7369.2024.08.009
文献标志码:
A
摘要:
目的:探讨参芪真武汤加味治疗原发性肾病综合征效果及对患者肾功能、微炎状态、凝血纤溶功能的影响。方法:选取脾肾阳虚证原发性肾病综合征患者110例,根据治疗方案分为两组,观察组和对照组各55例。对照组给予常规对症治疗,观察组在对照组基础上给予参芪真武汤加味治疗,两组均连续治疗8周。比较两组治疗总有效率及不良反应发生情况,同时观察治疗前后中医证候积分、肾功能[24 h尿蛋白定量(24 hTP)、血白蛋白(ALB)、尿素氮(BUN)、血清肌酐(Cr)]、微炎状态[高敏-C反应蛋白(hs-CRP)、白细胞介素-21(IL-21)、白细胞介素-13(IL-13)]、凝血纤溶功能[纤维蛋白原(FIB)、D-二聚体(D-D)]变化情况。结果:观察组临床总有效率为90.91%,高于对照组的76.36%(P<0.05)。经治疗,观察组浮肿、面色白、畏寒肢冷、腰膝酸软、恶寒喜暖各项中医证候积分较对照组低(均P<0.05); 观察组ALB水平较对照组高,24 hTP、BUN、Cr较对照组低(均P<0.05); 观察组IL-13水平较对照组高,hs-CRP、IL-21水平较对照组低(均P<0.05)。两组FIB、D-D水平低于治疗前,且观察组低于对照组(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:参芪真武汤加味治疗原发性肾病综合征脾肾阳虚证可提高临床效果,降低中医证候积分,促进肾功能和凝血纤溶功能改善,减轻机体微炎症状态,且安全性佳。
Abstract:
Objective:To explore the effect of Shenqi Zhenwu decoction in the treatment of primary nephrotic syndrome and its influence on renal function,micro-inflammatory state,coagulation and fibrinolysis function.Methods:110 patients with primary nephrotic syndrome with spleen kidney yang deficiency syndrome were selected.They were divided into two groups according to the treatment plan,with 55 cases in the observation group and 55 cases in the control group.The control group received routine symptomatic treatment,while the observation group received modified Shenqi Zhenwu decoction treatment on the basis of the control group.Both groups were treated continuously for 8 weeks.Compare the total effective rate and incidence of adverse reactions between two groups.The traditional Chinese medicine syndrome scores,renal function [24-hour urine protein quantification(24 hTP),blood albumin(ALB),urea nitrogen(BUN),serum creatinine(Cr)],micro inflammatory status [high-sensitivity C-reactive protein(hs-CRP),interleukin-21(IL-21),interleukin-13(IL-13)],coagulation and fibrinolytic function [fibrinogen(FIB),D-dimer(D-D)] were observed before and after treatment.Results:The total effective rate of the observation group was 90.91%,which was significantly higher than 76.36% of the control group(P<0.05).After treatment,edema,pale complexion,cold limbs,lumbar debility,evil cold or warm score in the observation group were lower than the control group(all P<0.05).The level of ALB in the observation group was higher than that in the control group,and the 24 hTP,BUN and Cr were lower than those in the control group(all P<0.05).After treatment,the IL-13 in the observation group was higher than that in the control group,and the hs-CRP and IL-21 were lower than those in the control group(all P<0.05).FIB and D-D levels in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).There was no significant difference in adverse reactions(P>0.05).Conclusion:The modified Shenqi Zhenwu decoction in the treatment of primary nephrotic syndrome with spleen-kidney yang deficiency can improve the clinical effect,reduce the TCM syndrome score,promote the improvement of renal function and coagulation and fibrinolytic function,reduce the micro-inflammatory state of the body,and has good safety.

参考文献/References:

[1] 徐宇青,张权,张先闻,等.中西医方案联合胸腺五肽治疗原发性肾病综合征临床疗效分析[J].中国中西医结合肾病杂志,2021,22(10):874-877.
[2] 孙玉锋,范立华.中西医结合治疗原发性肾病综合征67例[J].河南中医,2022,42(2):260-263.
[3] 黄敏,杜珍芳,张红艳.IgA肾病从风、湿、瘀论治探讨[J].陕西中医,2022,43(4):499-501.
[4] 杜超,李颖珺,李骧.温阳利水汤治疗对脾肾阳虚型原发性肾病综合征患者临床疗效观察[J].实用医院临床杂志,2021,18(6):59-62.
[5] 耿芳,忽星歌,姜晨.真武汤在慢性肾脏病中临床及实验研究进展[J].辽宁中医药大学学报,2021,23(4):213-216.
[6] 贺梦媛,丛竹凤,王升光,等.真武汤化学成分、药理作用、临床应用的研究进展及质量标志物的预测分析[J].中华中医药学刊,2022,40(2):56-62.
[7] SHASHA L,XUE X,LING H,et al.Renoprotective effect of Zhenwu decoction against renal fibrosis by regulation of oxidative damage and energy metabolism disorder[J].Scientific Reports,2018,8(1):14627.
[8] 陈灏珠,林果为,王吉耀.实用内科学[M].14版.北京:人民卫生出版社,2013:2161.
[9] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:68.
[10] 中国成人肾病综合征免疫抑制治疗专家组.中国成人肾病综合征免疫抑制治疗专家共识[J].中华肾脏病杂志,2014,30(6):467-474.
[11] 叶任高,陈裕盛,方敬爱.肾脏病诊断与治疗及疗效标准专题讨论纪要[J].中国中西医结合肾病杂志,2003,5(5):249-251.
[12] THOMAS M,JOHN H,OMAR R,et al.Longitudinal analysis of prophylactic anticoagulation in primary nephrotic syndrome:Low incidence of thromboembolic complications.[J].Glomerular Diseases,2023,3(1):266-274.
[13] 解艳欢.原发性肾病综合征免疫发病机制研究[J].医学信息,2023,36(20):189-192.
[14] LI X,LEIG A.Discussion on TCM treatment and the pathogenesis of membranous nephropathy in primary nephrotic syndrome[J].Proceedings of Anticancer Research,2022,6(4):26-30.
[15] 张菊.昆仙胶囊治疗肾病综合征疗效及对患者血清IFN-γ和IL-21水平的影响[J].陕西医学杂志,2020,49(3):345-348.
[16] 黄子微,马鸿杰.经方治疗原发性肾病综合征研究进展[J].山东中医杂志,2019,38(9):890-893.
[17] 宋菊.加味防己黄芪汤对原发性肾病综合征微炎状态及Toll样受体相关蛋白的影响[J].陕西中医,2019,40(4):478-480.
[18] 阮冬冬.真武汤治疗成人原发性肾病综合征的meta分析及作用机制探讨[D].武汉:湖北中医药大学,2021.
[19] 张璐,王建,赵艳玲.附子与干姜配伍的药理学研究进展[J].中国医院用药评价与分析,2018,18(11):1441-1443,1446.
[20] 陈海霞.温肾健脾、化气行水法治疗脾肾阳虚型原发性肾病综合征的临床疗效及对微炎症状态的影响[D].济南:山东中医药大学,2023.
[21] 李贵明,李燕.人参皂苷药理作用研究现状[J].中国临床药理学杂志,2020,36(8):1024-1027.
[22] 姜辉,顾胜龙,张玉婷,等.黄芪化学成分和药理作用研究进展[J].安徽中医药大学学报,2020,39(5):93-96.
[23] 杨雪梅.瑞舒伐他汀联合那曲肝素钙治疗原发性肾病综合征的疗效及对肾功能、凝血功能的影响[J].血栓与止血学,2021,27(2):281-282.
[24] 符利梅,盛哲,杨丹,等.凝血6项联合血小板相关指标在儿童初发原发性肾病综合征中的诊断价值[J].检验医学与临床,2023,20(8):1086-1089.
[25] 刘海波,卢佩,李春梦,等.肾病综合征患者凝血指标检测价值分析[J].陕西医学杂志,2020,49(4):506-509.

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备注/Memo

备注/Memo:
基金项目:广东省科技厅科技计划项目(2022A0505020029); 广东省佛山市科学技术局自筹经费类科技创新项目(2220001005371)
更新日期/Last Update: 2024-08-08