首页|基于肠源性毒素探讨排毒保肾丸治疗慢性肾脏病疗效机制

基于肠源性毒素探讨排毒保肾丸治疗慢性肾脏病疗效机制

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目的:基于肠源性内毒素明确排毒保肾丸治疗慢性肾脏病(Chronic Kidney Disease，CKD)的效应机制。方法:选取2020年3月～2021年7月于江西省中医肾病临床医学研究中心·九江市中医院肾病科住院的非透析CKD住院患者，随机分配入对照组和治疗组，每组各30例。在常规治疗基础上，对照组给予尿毒清颗粒，治疗组给予排毒保肾丸，连续治疗16 w。检测并比较各组治疗前后尿素氮、血肌酐、血尿酸(Uric Acid，UC)、胱抑素C(Cystatin C，Cysc)、二氧化碳结合力(Carbon Dioxide Binding Capacity，CO2CP)、三酰甘油(Triglyceride，TG)、总胆固醇(Total Cholesterol，TC)、血清白蛋白(Serum Albumin，ALB)、硫酸吲哚酚(Indoleol Sul-fate，IS)、硫酸对甲酚(P-cresol Sulfate，PCS)、C 反应蛋白(C-reactive Protein，CRP)、白细胞介素 6(Interleukin-6，IL-6)、肿瘤坏死因子-α(Tumor Necrosis Factor-α，TNF-α)、尿微量白蛋白(Urinary Microalbumin，u-mALB)、24 h 尿蛋白(24-hour urinary protein，UTP)含量变化;评估治疗前后中医证候积分，计算总有效率;检测肝功能及血钾评价安全性。结果:与治疗前比较，治疗组及对照组尿素氮、血肌酐、尿酸、ALB、TC、TG、IS、PCS、CRP、IL-6、TNF-α、u-mALB、UTP 含量均明显降低(P＜0。05)，治疗组 sIgA 含量明显升高(P＜0。05);与治疗前比较，治疗组及对照组中医证候积分明显降低(P＜0。05);治疗后，与对照组比较，治疗组尿素氮、血肌酐、尿酸、ALB、TC、TG、IS、PCS、CRP、IL-6、TNF-α、u-mALB、UTP含量均明显降低(P＜0。05或P＜0。01)，sIgA含量显著升高(P＜0。01)，治疗组积分改善更为明显(P＜0。05)。结论:排毒保肾丸治疗CKD具有较好的临床疗效，其可能通过降低肠道代谢毒素等环节而发挥治疗作用。
Mechanism of Paidu Baoshen(排毒保肾)Pills in Treatment of Chronic Kindey Disease Based on Intestinal Toxins
Objective:To investigate the effect and significance of Paidu Baoshen(排毒保肾)Pills in patients with CKD based on intestinal endo-toxins.Methods:Patients with CKD in the Department of nephrology,Jiujiang Hospital of Chinese Medicine from March 2020 to July 2021 were randomly assigned to the control group and treatment group,with 30 cases in each group.On the basis of routine treatment,the control group was given Niaodu Qing(尿毒清)granules and the treatment group was given Paidu Baoshen pills,for 16 weeks.Before and after treat-ment,urea nitrogen,creatinine,uric acid(UC),cystatin C(Cys C),carbon dioxide binding capacity(CO2CP),triglyceride(TG),total cho-lesterol(TC),serum albumin(ALB),indole sulfate(IS),p-cresol sulfate(PCS),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),urinary microalbumin(U-mAlb),and 24-hour urinary protein(UTP)were determined and compared.The tradi-tional Chinese medicine syndrome score was evaluated.Liver function and blood potassium were measured to evaluate its safety.Results:Compared with before treatment,the urea nitrogen,blood creatinine,uric acid,ALB,TC,TG,IS,PCS,CRP,IL-6,TNF-α,u-mALB and UTP were significantly decreased in the treatment group and control group(P＜0.05),sIgA in the treatment group was significantly increased(P＜0.05).Compared with baseline,The TCM syndrome score of the treatment group and the control group was significantly decreased(P＜0.05).After treatment,compared with the control group,the urea nitrogen,blood creatinine,uric acid,ALB,TC,TG,IS,PCS,CRP,IL-6,TNF-α,U-mALB and UTP in the treatment group was significantly decreased(P＜0.05 or P＜0.01),while the sIgA in the treatment group was sig-nificantly increased(P＜0.01),and the TCM score showed more significant improvement(P＜0.05).Conclusion:Paidu Baoshen pills have good clinical efficacy in the treatment of CKD,which may play a therapeutic role by reducing intestinal metabolic toxins and other parts.

Paidu Baoshen pills(排毒保肾)Chronic kidney disease(CKD)Intestinal metabolic toxinsEfficacy evaluation

傅奕、马伟、李鑫、魏林、伍宏泽、刘永芳、付义

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江西省中医肾病临床医学研究中心九江市中医院,九江 332000

榆林市中医医院治未病中心,榆林 719000

湖南中医药大学中医诊断学湖南省重点实验室,长沙 410208

排毒保肾丸 慢性肾脏病 肠源性毒素 疗效评价

国家自然科学基金地区科学基金江西省科技厅一般项目江西省卫生健康委科技项目江西省中医药科研项目榆林市科学技术研究与开发补助项目

8206083920212BAG70041202043052019A395YF-2021-71

2024

中药药理与临床
中国药理学会 四川省中医药科学院

中药药理与临床

北大核心
影响因子：0.996
ISSN：1001-859X
年,卷(期)：2024.40(3)
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