中西医结合优化治疗方案抑制IgA肾病肾纤维化的免疫机制(1)
摘要 目的：观察中西医结合优化方案治疗IgA肾病的临床疗效及改善肾纤维化的免疫机制。方法：选取2016年6月至2018年6月上海中医药大学附属曙光医院收治的IgA肾病患者40例作为研究对象，按照随机对照原则分为观察组和对照组，每组20例，观察组采用中药颗粒剂+氯沙坦的治疗方案，对照组采用中药模拟剂+氯沙坦的治疗方案，均治疗24周，治疗前后测定24 h尿蛋白定量、尿微量白蛋白/肌酐(MA/Cr)、血肌酐(Scr)、肾小球滤过率(eGFR)、白细胞介素6(IL-6)、转化生长因子β1(TGF-β1)。结果：观察组总有效率为80.0%，对照组为35.0%，2组患者比较差异有统计学意义(P<0.05)。观察组24 h尿蛋白定量、MA/Cr、Scr、eGFR较对照组显著改善(P<0.05)。观察组营养状态稳定，相关免疫机制尿IL-6得到显著改善(P<0.05)，致肾纤维化因子尿TGF-β1也显著降低(P<0.05)。结论：中西医联合观察组较单纯西药组在降低蛋白尿、保护肾功能方面有明显优势，对IL-6的调节作用是中西医结合优化治疗方案改善IgA腎病肾纤维化的重要机制。
关键词 IgA肾病;肾纤维化;免疫调节;中西医结合;抑制;机制;随机对照;中药颗粒;氯沙坦
Abstract Objective：To observe the clinical efficacy of the optimized integration traditional Chinese and western medicine in the treatment of IgA nephropathy and the immune mechanism of improving renal fibrosis.Methods：A total of 40 patients with IgA nephropathy admitted to Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2016 to June 2018 were selected as subjects.According to the principle of randomized control，they were divided into an observation group(traditional Chinese medicine granules+Losartan)and a control group(traditional Chinese medicine mimicking agent+Losartan)，with 20 cases in each group.The observation group was treated by traditional Chinese medicine granules+Losartan，and the control group was treated by traditional Chinese medicine mimicking agent+Losartan.All were treated for 24 weeks，and the 24 hours urinary protein quantitation，urinary microalbumin/creatinine(MA/Cr)，serum creatinine(Scr)and glomerular filtration rate(eGFR)，interleukin-6(IL-6)and transforming growth factor-β1(TGF-β1)were measured before and after treatment.Results：The total effective rate was 80.0% in the observation group and 35.0% in the control group，and the difference between the 2 groups was statistically significant(P<0.05).Compared with the control group，the 24 hours urinary protein quantitation，MA/Cr，Scr and eGFR in the treatment group were significantly improved(P<0.05).The nutritional status in the observation group was stable，and the related immune mechanism of urinary IL-6 was significantly improved(P<0.05)，and the renal fibrosis factor of urinary TGF-β1 was significantly decreased(P<0.05).Conclusion：Compared with the western medicine group，the observation group(integration traditional Chinese and western medicine)has obvious advantages in reducing proteinuria and protecting kidney function.The regulation of IL-6 is an important mechanism for improvement of renal fibrosis in IgA nephropathy by the optimal treatment scheme with integration traditional Chinese and western medicine., 百拇医药(张昕贤 高雅婵 何立群)
关键词 IgA肾病;肾纤维化;免疫调节;中西医结合;抑制;机制;随机对照;中药颗粒;氯沙坦
Abstract Objective：To observe the clinical efficacy of the optimized integration traditional Chinese and western medicine in the treatment of IgA nephropathy and the immune mechanism of improving renal fibrosis.Methods：A total of 40 patients with IgA nephropathy admitted to Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2016 to June 2018 were selected as subjects.According to the principle of randomized control，they were divided into an observation group(traditional Chinese medicine granules+Losartan)and a control group(traditional Chinese medicine mimicking agent+Losartan)，with 20 cases in each group.The observation group was treated by traditional Chinese medicine granules+Losartan，and the control group was treated by traditional Chinese medicine mimicking agent+Losartan.All were treated for 24 weeks，and the 24 hours urinary protein quantitation，urinary microalbumin/creatinine(MA/Cr)，serum creatinine(Scr)and glomerular filtration rate(eGFR)，interleukin-6(IL-6)and transforming growth factor-β1(TGF-β1)were measured before and after treatment.Results：The total effective rate was 80.0% in the observation group and 35.0% in the control group，and the difference between the 2 groups was statistically significant(P<0.05).Compared with the control group，the 24 hours urinary protein quantitation，MA/Cr，Scr and eGFR in the treatment group were significantly improved(P<0.05).The nutritional status in the observation group was stable，and the related immune mechanism of urinary IL-6 was significantly improved(P<0.05)，and the renal fibrosis factor of urinary TGF-β1 was significantly decreased(P<0.05).Conclusion：Compared with the western medicine group，the observation group(integration traditional Chinese and western medicine)has obvious advantages in reducing proteinuria and protecting kidney function.The regulation of IL-6 is an important mechanism for improvement of renal fibrosis in IgA nephropathy by the optimal treatment scheme with integration traditional Chinese and western medicine., 百拇医药(张昕贤 高雅婵 何立群)
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