健脾清化方改善慢性肾脏病2—3期患者微炎症状态的研究

目的观察健脾清化方治疗慢性肾脏疾病（CKD）2—3期脾虚湿热型患者微炎症状态的作用。方法将156例中医辨证为脾虚湿热的CKD2—3期患者随机分成中药组和对照组各78例，并设20例健康体检患者为正常组。对照组予以纠正水、电解质紊乱，现代营养治疗等治疗。中药组在对照组治疗基础上加用健脾清化方治疗，疗程为8周，观察两组患者治疗前后肾功能、微炎症指标的变化。结果最终中药组有74例、对照组有73例完成研究。治疗前，两组的超敏CRP（hs—CRP）、白介素－17（IL－17）、干扰素－7（IFN-7）比正常组显著升高（P〈0．05）。8周治疗后，中药组中医症候积分、血清肌酐（Scr）、尿素氮（BuN）、24小时尿蛋白定量均有明显下降且优于对照组（P〈0．05或P〈0．01），中药组hs-CRP平均下降了26．4％（P〈0．05），而对照组有上升的趋势。中药组IL-17平均下降了73．5％（P〈0．05），对照组平均下降了25．6％。中药组IFN-7平均下降了48．3％，P〈0．05），而对照组平均下降了23．3％。结论CKD2—3期的脾虚湿热型患者存在微炎症状态，健脾清化方能改善患者的微炎症状态，延缓肾功能进展，降低蛋白尿，延长非透析治疗时间，是一种安全、有效且容易被患者接受的治疗方法，适用于CKD早中期中医辨证为脾虚湿热的患者。

Study of "Jian Pi Qing Hua Decoction" on Micro-inflammatory State in CKD2-3

Objective To study the effects of ＂Jian Pi Qing Hua Decoction＂ on microinflammatory state in patiente of syndrome of dampness-heat due to spleen deficiency in CKD2-3. Methods Randomized control clinical study of 156 patients, the patients were divided into traditional Chinese drug group and control group, and 20 normal persons as normal group. Patients in normal group were accept conventional therapy of modern medicine, and the patients in traditional Chinese drug group were plus ＂Jian Pi Qing Hua Decoction＂. The concentration of renal funtion, micro-inflammatory markers were tested before and after treatment by 8 weeks. Results There were 74 patients in traditional Chinese drug group and 73 patients in control group. The concentration of hs-CRP, IL-17 and IFN-γof all patients were significantly increased than normal group（P〈0.05）. The concentration of TCM syndrome score, Ser, BUN, 24-hour urinary protein in traditional Chinese drug group was sig- nificantly decreased after treatment（P〈0.05 or P〈0.01）. The concentration of hs-CRP was signifi- cantly decreased 26. 4% after treatment in traditional Chinese drug group（P%0.05）, and that in control group was increased. The concentration of IL-17 was significantly decreased 73. 5% after treatment in traditional Chinese drug group（P〈0.05）, and that in control group was decreased 25.6%. The concentration of IFN-7 was significantly decreased 48.3 % after treatment in traditional Chinese drug group （P〈0.05）, and that in control group was decreased 23.3%. Conclusions Microinflammatory state was existed in patientes of syndrome of dampness-heat due to spleen deficiency in CKD2-3. ＂Jian Pi Qing Hua Decoction＂ can improve microinflammatory state in theses patients.