刺梨干粉对CKD3-4期脾肾气虚夹湿型患者氧化应激相关指标的影响

Clinical Study of Cili Powder on Oxidative Stress of CKD 3-4 Patients with Dampness Accumulation Associated with Spleen Kidney Deficiency

摘要:

目的: 通过对慢性肾脏病(CKD)3-4期患者服用刺梨干粉治疗前后氧化应激指标、肾纤维化指标及中医证候疗效评价,探讨其延缓慢性肾衰竭的进程及抗肾间质纤维化的作用机制. 方法: 90例患者采用随机数字表法分为治疗组、对照组,每组各45例,两组均予西医基础治疗(控制高血压、高血钾,调节钙磷代谢紊乱等).其中,治疗组在西医基础治疗上口服刺梨干粉20 g/次,2次/d,饭后吞服;对照组在西医治疗基础上口服尿毒清颗粒治疗,4周为1个疗程,共3个疗程.治疗前后均检测血肌酐(SCr),超氧化物歧化酶(SOD),丙二醛(MDA),转化生长因子-β(TGF-β),肿瘤坏死因子-α(TNF-α).在治疗前及治疗每个疗程结束后监测电解质、肝功能、粪便潜血、心电图等安全性指标. 结果: 刺梨干粉能降低CKD3-4期患者的SCr,下调TGF-β,TNF-α表达,减少MDA含量,增加SOD活性,能有效改善慢性肾衰竭患者中医临床症状,与尿毒清颗粒相比无显著性差异.表明刺梨干粉能减轻CKD患者体内氧化应激反应,延缓肾间质纤维化的进展. 结论: 初步证实刺梨干粉能改善肾间质纤维化、延缓慢性肾衰竭进展,安全性好.其作用机制可能与其清除体内氧自由基有关.

Abstract:

Objective: To explore the mechanisms of Cili powder in delaying the progression of chronic renal failure and against the renal interstitial fibrosis by investigating oxidative stress index, renal fibrosis index, and traditional Chinese medical (TCM) syndrome in chronic kidney diseases (CKD) 3-4 patients. Method: Ninty patients were, divided into treatment group and control group using random number table of 45 patients each group. Patients in both 2 groups received conventional western medicine treatment (for hypertension, hyperkalemia and calcium-phosphorus metabolism disorder control, etc.). The patients in treatment group added Cili powder orally, 20 g twice daily after supper. and the patients in the control group added Niaoduqing particles orally for 3 4-week periods of treatment. Serum creatinine (SCr), superoxide dismutase (SOD), malondialdehyde (MDA), transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α) were observed before and after the treatment. The security index of electrolyte, liver function, fecal occult blood, electrocardiogram, etc. were monitored before and after every period of treatment. Result: The Cili powder could reduce the serum creatinine, TGF-β, TNF-α and MDA content, and increase the activity of SOD in CKD 3-4 patients. It also can improve the clinical TCM symptoms with no significant difference as compared with Niaoduqing particle. Furthermore, Cili powder could decrease the reaction of oxidative stress in CKD patients and delay the progress of renal interstitial fibrosis. Conclusion: The Cili powder has definite effect in improving renal interstitial fibrosis, delaying the progress of chronic renal failure, and has high safety. Its mechanisms of action may be related to eliminating oxygen radicals in body.