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目的:观察清肾颗粒对慢性肾衰竭(CRF)湿热证患者血清纤维连接蛋白(FN)和α-平滑肌肌动蛋白(α-SMA)的影响。方法:70例CRF湿热证患者随机分为对照组和治疗组各35例,实际完成64例(对照组31例,治疗组33例),并选取20名健康体检者作为正常组。治疗组与对照组均给予西医基础治疗,治疗组加用清肾颗粒,每次1袋(10g),每日3次口服,疗程8周。检测两组临床疗效及治疗前后血肌酐(Scr)、肾小球滤过率估算值(e GFR)、FN、α-SMA水平变化情况,并与正常组比较。结果:治疗组临床疾病总有效率为78.79%,中医证候总有效率81.82%,分别优于对照组的54.84%和51.61%(P<0.05);治疗组治疗后Scr水平较治疗前显著下降,e GFR水平显著升高,且与同期对照组相比有明显差异(P<0.05);治疗组和对照组患者治疗前的血清FN、α-SMA水平均显著高于正常组(P<0.01),治疗后两组血清FN、α-SMA水平较治疗前均有显著下降(P<0.05,P<0.01),且治疗组的下降幅度大于对照组(P<0.05)。结论:清肾颗粒可以减轻CRF湿热证患者临床症状,改善肾功能,降低血清FN、α-SMA的水平,干预肾纤维化,最终延缓CRF进展。
Objective: To observe the effects of Qing Shen Granules on serum fibronectin (FN) and α-smooth muscle actin (α-SMA) in patients with chronic renal failure (CRF) damp-heat syndrome. Methods: Seventy patients with CRF damp-heat syndrome were randomly divided into control group and treatment group, 35 cases in each group, 64 cases were actually completed (control group, 31 cases, treatment group, 33 cases) and 20 healthy subjects were selected as normal group. The treatment group and the control group were given Western medicine treatment. The treatment group was treated with Qing Shen Granules (10g) once a day for three times daily for 8 weeks. The changes of clinical efficacy, serum creatinine (Scr), estimated glomerular filtration rate (e GFR), FN and α-SMA levels before and after treatment were compared between the two groups. Results: The total effective rate of clinical disease in treatment group was 78.79%, and the total effective rate of TCM syndrome was 81.82%, which was 54.84% and 51.61% (P <0.05) better than that in control group respectively. The Scr level in treatment group decreased significantly after treatment (P <0.05). The levels of serum FN and α-SMA in the treatment group and the control group before treatment were significantly higher than those in the normal group (P <0.01) ), The levels of serum FN and α-SMA in both groups were significantly decreased after treatment (P <0.05, P <0.01), and the decrease in the treatment group was greater than that in the control group (P <0.05). Conclusion: Qing Shen Granule can relieve clinical symptoms, improve renal function, reduce serum FN and α-SMA levels, interfere with renal fibrosis and finally delay CRF progression in patients with CRF damp-heat syndrome.