温肾通络汤对慢性肾脏病3、4期患者肾功能、氧化应激、血管新生及免疫指标的影响

Effects of Wenshen Tongluo Decoction on renal function, oxidative stress, angiogenesis and immune parameters in patients with chronic kidney disease stages 3 and 4

摘要:

目的 探讨温肾通络汤治疗对慢性肾脏病(CKD)3、4期患者肾功能、氧化应激指标、血管新生及免疫功能的影响。方法 选取2016年1月至2018年6月期间在昆山市中医医院接受诊治的CKD患者98例为研究对象。采用随机数字表法分为2组:研究组和对照组,每组49例。2组患者均给予西医基础治疗,研究组在西医治疗基础上同时服用温肾通络汤治疗。对比2组患者治疗前和治疗8周后的尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)、血清胱抑素C(Cys-C)、中医症候积分、丙二醛(MDA)、超氧化物歧化酶(SOD)、血管内皮生长因子(VEGF)、内皮抑素(ES)、外周血T淋巴细胞水平。采用SPSS 21.0统计软件对数据进行分析。根据数据类型,组间比较采用t检验或χ²检验。结果 与治疗前相比,2组患者治疗后的各指标水平均显著改善(P<0.05)。与对照组相比,治疗后研究组患者的BUN[(7.20±1.33)和(8.01±1.40)mmol/L]、SCr[(126.0±15.3)和(134.2±18.2)μmol/L]、UA[(380.1±27.4)和(395.8±24.0)μmol/L]、Cys-C[(1.28±0.21)和(1.43±0.23)mg/L]、VEGF[(35.2±5.0)和(39.7±6.1)pg/ml]、ES[(37.2±6.8)和(41.8±7.3)ng/ml]水平均显著降低(P<0.05),而CD3⁺[(59.6±4.0)%和(57.3±3.5)%]、CD4⁺[(38.8±3.0)%和(36.9±3.3)%]、CD4⁺/CD8⁺[(1.49±0.21)和(1.33±0.18)]和SOD[(90.6±13.8)和(81.8±14.0)U/ml]水平显著增高(P<0.05)。治疗后,研究组患者的中医症候评分也显著低于对照组[(8.5±2.7)和(11.0±3.0)分,P<0.05]。结论 温肾通络汤能有效改善CKD 3、4期患者的肾功能、氧化应激指标、血管新生及免疫功能。

Abstract:

Objective To investigate the effects of Wenshen Tongluo Decoction on the renal function, oxidative stress, angiogenesis and immune parameters in the patients with chronic kidney disease (CKD) stages 3 and 4. Methods A total of 98 CKD patients admitted to our hospital from January 2016 to June 2018 were enrolled, and randomly divided into study group and control group, with 49 cases in each group. The patients of both groups were given basic medical treatment of western medicine, and those of the study group were added with Wenshen Tongluo Decoction. Before and 8 weeks after treatment, their urea nitrogen (BUN), serum creatinine (SCr), uric acid (UA), serum cystatin C (Cys-C), Traditional Chinese Medicine (TCM) syndrome scores, malondialdehyde (MDA), superoxide dismutase (SOD), vascular endothelial growth factor (VEGF), endostatin (ES), and peripheral blood T lymphocytes were measured and compared between the 2 groups. SPSS statistics 21.0 was used to analyze the data. Student′s t test or Chi-square test was employed for comparison between groups. Results After treatment, the above levels and indicators were significantly improved in both group (P<0.05). The study group had significantly lower BUN [(7.20±1.33) vs (8.01±1.40)mmol/L], SCr [(126.0±15.3) vs (134.2±18.2)μmol/L], UA [(380.1±27.4) vs (395.8±24.0)μmol/L], Cys-C [(1.28±0.21) vs (1.43±0.23)mg/L], VEGF [35.2±5.0) vs (39.7±6.1)pg/ml] and ES [(37.2±6.8) vs (41.8±7.3)ng/ml], and obviously increased percentages of CD3⁺ [(59.6±4.0)% vs (57.3±3.5)%] and CD4⁺ cells [(38.8±3.0)% vs (36.9±3.3)%], higherCD4⁺/CD8⁺ ratio [(1.49±0.21) vs (1.33±0.18)] and SOD level [(90.6±13.8) vs (81.8±14.0)U/ml] when compared with the control group (all P<0.05). After treatment, the TCM symptom scores were notably lower in the study group than in the control group [(8.5±2.7) vs (11.0±3.0), P<0.05]. Conclusion Wenshen Tongluo Decoction can effectively improve renal function, oxidative stress indicators, angiogenesis and immune parameter in the patients with stages 3 and 4 CKD.