摘要
目的观察扶阳畅络方治疗特发性膜性肾病(IMN)的疗效及对血免疫细胞及相关细胞因子、尿人末端补体复合物(C5b-9)、免疫球蛋白4(IgG4)和血清抗M型磷脂酶A2受体(PLA2R)抗体、1型血小板反应蛋白7A域(THSD7A)抗体的影响。方法将110例IMN患者按照随机数字表法分为2组,对照组55例予常规对症治疗,治疗组55例在对照组治疗基础上加扶阳畅络方治疗。2组均4周为1个疗程,治疗3个疗程。比较2组疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后外周血免疫细胞含量变化;比较2组治疗前后尿C5b-9、IgG4含量变化;比较2组治疗前后血清PLA2R抗体、THSD7A抗体阳性率变化。结果治疗组总有效率98.18%(54/55),对照组总有效率89.09%(49/55),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候水肿、腰脊痠痛、体倦乏力、食少纳呆、夜尿评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后白细胞介素17(IL-17)、肿瘤坏死因子α(TNF-α)含量及辅助性T细胞17(Th17)、Th17/调节性T细胞(Treg)均降低(P<0.05),且治疗组降低更明显(P<0.05);转化生长因子β1(TGF-β1)含量、Treg均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后尿C5b-9、IgG4含量均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血清PLA2R、THSD7A抗体阳性率均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论扶阳畅络方治疗IMN,可有效改善患者外周血免疫失衡,降低尿C5b-9、IgG4含量,促进血清PLA2R、THSD7A抗体转阴。
Objective To observe the effect of Fuyang Changluo Formula for imbalance of peripheral blood,terminal complement complex C5b-9,immunoglobulin G4(IgG4),serum anti-m-type phospholipase A2 receptor(PLA2R)antibody,and thrombospondin type-1 domain-containing 7A(THSD7A)antibody in patients with idiopathic membranous nephropathy(IMN).Methods Totally 110 IMN patients were randomly divided into 2 groups,55 cases in treatment group were treated with Fuyang Changluo Formula combined with conventional therapy,and 55 in control group with conventional trerapy alone.Treated for 12 weeks,aiming to compare traditional Chinese medicine(TCM)symptom score,immune change of peripheral blood,content of C5b-9 and IgG4,the positive rate of serum levels of anti-PLA2R antibodies and THSD7A antibodies,the curative effect was counted.Results The total effective rates in treatment group were better than those in control group[98.18%(54/55)vs 89.09%(49/55),(P<0.05),respectively].After treatment,TCM symptom(edema,Low back pain,weary and hypodynamia,poor appetite and anorexia,nocturia)scores in groups were decreased(P<0.05),which decreased notably in treatment group when compared with cortrol group(P<0.05);the content of interlukin-17(IL-17),tumor necrosis factor(TNF-α),and the proportion of Th17 cells,Th17/Treg cells in groups remarkably decreased(P<0.05),improvement of which in treatment group were significantly better(P<0.05);the content of transforming growth factor 1(TGF-β1)and the proportion of Treg cells were remarkably increased(P<0.05),which in treatment group increased significantly(P<0.05);the content of C5b-9 and IgG4 were remarkably decreased(P<0.05),which were significantly decreased in treatment group than in control group(P<0.05);the positive rate of serum levels of anti-PLA2R antibody and THSD7A antibody in groups were remarkably decreased(P<0.05),which in treatment group decreased significantly(P<0.05).Conclusion For IMN patients,Fuyang Changluo Formula can effectively improve peripheral blood immune imbalance,reduce content of C5b-9 and IgG4,and promote serum levels of anti-PLA2R antibodies and THSD7A antibodies to turn negative.
作者
李法芳
LI Fafang(Department of Nephrology,Heze Hospital of Traditional Chinese Medicine,Shandong,Heze 274000)
出处
《河北中医》
2021年第9期1462-1466,共5页
Hebei Journal of Traditional Chinese Medicine
基金
山东省中医药管理局2017—2018年度山东省中医药科技发展计划项目(编号:2017-509)。
关键词
肾小球肾炎
膜性
中药疗法
Glomerulonephritis,membranous
Traditional Chinese medicine therapy
