1. 上海中医药大学附属岳阳中西医结合医院肾病科,上海,200437
2. 上海中医药大学附属岳阳中西医结合医院闵行分院中医科,上海,200241
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王祎熙, 须冰, 岑洁, 等. 无比山药丸加减方对脾肾两虚型慢性肾盂肾炎患者免疫应答影响的临床研究[J]. 上海中医药杂志, 2018,52(4):53-55.
WANG Yixi, XU bing, CEN Jie, et al. Effects of modified Wubi Shanyao Pill on immune response in patients of chronic pyelonephritis with syndrome of deficiency of both spleen and kidney[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(4):53-55.
王祎熙, 须冰, 岑洁, 等. 无比山药丸加减方对脾肾两虚型慢性肾盂肾炎患者免疫应答影响的临床研究[J]. 上海中医药杂志, 2018,52(4):53-55. DOI: 10.16305/j.1007-1334.2018.04.015.
WANG Yixi, XU bing, CEN Jie, et al. Effects of modified Wubi Shanyao Pill on immune response in patients of chronic pyelonephritis with syndrome of deficiency of both spleen and kidney[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(4):53-55. DOI: 10.16305/j.1007-1334.2018.04.015.
目的:观察无比山药丸加减方治疗脾肾两虚型慢性肾盂肾炎的临床疗效及其对免疫应答功能的影响。 方法:将90例脾肾两虚型慢性肾盂肾炎患者随机分为治疗组与对照组,每组45例。对照组予西医常规抑菌疗法,治疗组在对照组治疗措施基础上加服无比山药丸加减方。两组疗程均为1个月,观察临床疗效及复发率,比较体液免疫及细胞免疫相关指标,包括血清免疫球蛋白(IgA、IgG、IgM)、补体C3、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)及外周血单个核细胞Toll样受体TLR4的阳性表达率。 结果:①治疗组、对照组临床总有效率分别为93.3%、77.8%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。②治疗前后组内比较,治疗组IgA、IgG、补体C3水平明显增高(P<0.05),而对照组IgA、IgG、IgM、补体C3水平差异无统计学意义(P>0.05);组间治疗后比较,IgA、IgG、补体C3水平差异有统计学意义,治疗组明显高于对照组(P<0.05)。③治疗前后组内比较,两组IL-6、TNF-α水平及TLR4阳性表达率差异均有统计学意义(P<0.05);组间治疗后比较,IL-6、TNF-α水平及TLR4阳性表达率差异有统计学意义,治疗组明显低于对照组(P<0.05)。④随访期间,治疗组受试者复发8例(8/42)、对照组复发18例(18/35),治疗组复发总频次11次、对照组复发总频次25次;组间复发率比较,治疗组明显低于对照组(P<0.05)。 结论:无比山药丸加减方联合西医常规抑菌疗法治疗慢性肾盂肾炎的疗效满意,可明显降低复发率,调节患者免疫应答功能,抑制其炎症状态。
Objective:To observe the clinical efficacy of modified Wubi Shanyao Pill in the treatment of chronic pyelonephritis with syndrome of deficiency of both spleen and kidney,as well as its effects on immune response function. Methods90 patients of chronic pyelonephritis with syndrome of deficiency of both spleen and kidney were randomly divided into the treatment group and control group,45 cases in each group. The control group was treated with conventional bacteriostasis therapy,and the treatment group was treated with modified Wubi Shanyao Pill based on the treatment for the control group,with a course of one month. The clinical efficacy and recurrence rate were observed. And the related indexes of humoral immunity and cellular immunity were compared,including serum immunoglobulin (IgA,IgG,IgM),complement C3,interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and positive expression rate of Toll like receptor 4 (TLR4) in peripheral blood mononuclear cells. Results: ①The clinical total effective rates were 93.3% in the treatment group and 77.8% in the control group. The clinical efficacy of the treatment group was significantly better than that of the control group (P<0.05). ②Compared with treatment before,the levels of IgA,IgG and complement C3 in the treatment group were significantly increased after treatment (P<0.05);while in the control group,there were no statistically significant differences on the levels of IgA,IgG,IgM and complement C3 between treatment before and after (P>0.05). After treatment,there were statistically significant differences on the levels of IgA,IgG and complement C3 between the two groups,and the levels in the treatment group were significantly higher than those in the control group (P<0.05). ③For the comparison between treatment before and after,there were statistically significant differences on the levels of IL-6 and TNF-α and positive expression rate of TLR4 in both groups (P<0.05). After treatment,there were statistically significant differences on the levels of IL-6 and TNF-α and positive expression rate of TLR4 between the two groups,and the levels of IL-6 and TNF-α and the positive expression rate of TLR4 in the treatment group were significantly lower than those in the control group (P<0.05). ④During the follow-up,there were 8 cases with recurrence in the treatment group(8/42) and 18 cases with recurrence in the control group (18/35). The total recurrence frequencies were 11 times in the treatment group and 25 times in the control group. The recurrence rate of the treatment group was significantly lower than that of the control group (P<0.05). Conclusion:Modified Wubi Shanyao Pill combined with conventional bacteriostasis therapy of western medicine shows satisfactory efficacy in the treatment of chronic pyelonephritis,which can significantly decrease the recurrence rate,regulate the immune response function and inhibit the inflammatory state in patients.
慢性肾盂肾炎脾肾两虚证无比山药丸免疫应答抗炎抑菌
chronic pyelonephritissyndrome of deficiency of both spleen and kidneyWubi Shanyao Pillimmune responseanti-inflammation and bacteriostasis
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