肾络通汤对慢性肾小球肾炎患者TGF-，MMP-9和TMP-1因子的影响

黄东华; 何红涛; 檀银川

doi:10.13422/j.cnki.syfjx.2017150196

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肾络通汤对慢性肾小球肾炎患者TGF-，MMP-9和TMP-1因子的影响

临床 | 更新时间：2024-01-04

- 肾络通汤对慢性肾小球肾炎患者TGF-，MMP-9和TMP-1因子的影响
- Effect of Shenluotong Decoction on TGF-, MMP-9 and TMP-1 in Chronic Glomerulonephritis
- 中国实验方剂学杂志 2017年23卷第15期页码：196-201
- 作者机构：
- 作者简介：
- 基金信息：
  
  河北省卫生厅科研基金项目（201204061）
- DOI：10.13422/j.cnki.syfjx.2017150196
  中图分类号： R277.5
- 纸质出版日期：2017
- 稿件说明：
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黄东华, 何红涛, 檀银川. 肾络通汤对慢性肾小球肾炎患者TGF-，MMP-9和TMP-1因子的影响[J]. 中国实验方剂学杂志, 2017,23(15):196-201.

HUANG Dong-hua, HE Hong-tao, TAN Yin-chuan. Effect of Shenluotong Decoction on TGF-, MMP-9 and TMP-1 in Chronic Glomerulonephritis[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(15): 196-201.
黄东华, 何红涛, 檀银川. 肾络通汤对慢性肾小球肾炎患者TGF-，MMP-9和TMP-1因子的影响[J]. 中国实验方剂学杂志, 2017,23(15):196-201. DOI： 10.13422/j.cnki.syfjx.2017150196.

HUANG Dong-hua, HE Hong-tao, TAN Yin-chuan. Effect of Shenluotong Decoction on TGF-, MMP-9 and TMP-1 in Chronic Glomerulonephritis[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(15): 196-201. DOI： 10.13422/j.cnki.syfjx.2017150196.

摘要

目的：观察肾络通汤治疗慢性肾小球肾炎气虚血瘀证的临床疗效，并从抗炎和抗纤维化方面探讨其作用机制。方法：将140例慢性肾小球肾炎患者，采用分层区组，随机按数字表法分为对照组和观察组。对照组给予双嘧达莫片，50 mg/次，3次/d，口服；盐酸贝那普利片，10 mg/次，1次/d，口服。血脂异常者加用阿托伐他汀钙片，20 mg/次，1次/d，晚餐后口服。观察组西医处理措施同对照组，并加用肾络通汤，1剂/d。两组均连续服用16周。进行24 h尿蛋白定量（24 h UPR），血清白蛋白（ALB），肌酐（SCr），尿素氮（BUN）和尿常规检查，并计算肾小球滤过率（GFR）；进行气虚血瘀证评分；检测肿瘤坏死因子-α（TNF-α），白细胞介素-6（IL-6），IL-1β，Ⅰ型前胶原（PCⅠ），Ⅲ型前胶原（PCⅢ），透明质酸（HA）和层黏连蛋白（LN），转化生长因子 -β1（TGF-β1），基质金属蛋白酶-9（MMP-9）和金属蛋白酶组织抑制剂-1（TMP-1）水平；治疗前后各检测1次。结果：观察组临床疗效有效率为87.69%，高于对照组的73.02%，（χ2=4.384，P <0.05）；观察组中医证候疗效总有效率为90.77%，高于对照组的74.6%（χ2=5.874，P <0.05）；治疗后观察组24 h UPR，SCr，BUN，尿红细胞均低于对照组，ALB高于对照组（P<0.05，P <0.01）；治疗后观察组GFR较治疗前升高（P<0.01），并高于治疗后对照组（P<0.05）；治疗后观察组血清TNF-α，IL-6和IL-1β 水平均低于对照组（P<0.01）；治疗后观察组患者血清PCⅠ，PCⅢ，HA和LN水平均低于对照组（P<0.01）；治疗后观察组患者血清TGF-β1和TMP-1水平均低于对照组（P<0.01），MMP-9和MMP-9/TMP-1均高于对照组（P<0.05，P <0.01）。结论：肾络通汤治疗CGN气虚血瘀证患者能减轻患者的蛋白尿，改善肾功能，提高血清白蛋白，减轻临床症状，提高疾病疗效和中医证候疗效，其作用机制可能与减轻炎症反应，调节TGF-β1，MMP-9和TMP-1等因子，抑制肾纤维化有关。

Abstract

Objective: To observe the clinical efficacy of Shenluotong decoction for chronic glomerulonephritis with Qi and blood stasis and to discuss its mechanism from anti-inflammatory and anti-fibrosis factors. Method: One hundred and forty patients with chronic glomerulonephritis were randomly divided into control group and observation group by random number table. In control group

the patients received dipyridamole tablets

50 mg/time

3 times/day

benazepril hydrochloride tablets

10 mg/time

1 time/day. For patients with dyslipidemia

added atorvastatin calcium tablets

20 mg/time

1 time/day after supper by oral administration. Based on the treatment of control group

patients in observation group added Shenluotong decoction formulation granules

1 dose/day. The treatment course was 16 weeks in both groups. 24 hours' urinary protein quantification (24 h UPR)

serum albumin

creatinine (SCr)

urea nitrogen (Bun)

urine routine examination were recorded. Glomerular filtration rate (GFR) was calculated. And the scores of Qi and blood stasis were graded. Before and after treatment

levels of tumor necrosis factor-α(TNF-α)

interleukin-6 (IL-6)

IL-1β

type Ⅰ Pre-collagen(PC Ⅰ)

type Ⅲ Pre-collagen (PC Ⅲ)

hyaluronic acid (HA)

laminin (LN)

transforming growth factor-β 1(TGF-β 1)

matrix metalloproteinases-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TMP-1) were detected. Result: The clinical effective rate in observation group was 87.69%

higher than 73.02% in control group(χ2=4.384

P<0.05)

and the total effective rate for traditional Chinese medicine(TCM) syndrome was 90.77% in observation group

higher than 74.6% in control group(χ2=5.874

P<0.05). Levels of 24 h UPR

SCr

BUN and Urinary red blood cells in observation group were lower than those in control group

and level of serum albumin was higher than that in control group (P<0.05 or P<0.01) after treatment. As compared with the data before treatment

GFR was increased (P<0.01)

in observation group after treatment

and it was higher than that in control group (P<0.01). Levels of TNF-α

IL-6 and IL-1β and PC Ⅰ

PC Ⅲ

HA and LN and TGF-β 1 and TMP-1 in observation group were lower than those in control group (P<0.01)

and MMP-9 and MMP-9/TMP-1 ratio were higher than those in control group (P<0.05 or P<0.01). Conclusion: Shenluotong decoction formulation granules can relieve proteinuria and clinical symptoms

ameliorate renal function

improve serum albumin

increase disease efficacy and TCM syndrome effect in the patients with chronic glomerulonephritis with Qi and blood stasis

and its mechanism may be associated with reducing the inflammatory response

regulating levels of TGF-β 1

MMP-9 and TMP-1

and inhibiting renal fibrosis.

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