益气养阴方配合他克莫司治疗肾病综合征患者肾功能、外周血Th17/Treg免疫平衡、NF-κB信号转导通路的影响OA
Effects of Yiqi Yangyin prescription combined with tacrolimus on renal function,Th17/Treg immune balance in peripheral blood and NF-κB signal transduction pathway in patients with nephrotic syndrome
目的:探讨益气养阴方配合他克莫司在肾病综合征(NS)患者中的治疗效果.方法:选取124例NS患者,随机分为两组,各62例.两组均予以常规治疗,于此基础上,对照组予以他克莫司,观察组予以益气养阴方配合他克莫司,连续治疗12周.比较两组临床疗效、治疗前后中医证候积分、血尿素氮(BUN)、调节性T细胞(Treg)、血清肌酐(Cr)、24 h尿蛋白定量(24 hUpro)、辅助性T细胞17(Th17)、Th17/Treg、外周血核因子-κB(NF-κB)、Toll样受体4(TLR4)水平及不良反应.结果:观察组临床总有效率93.55％高于对照组的80.65％(P＜0.05);治疗6周、12周后观察组主症、次症及总积分均低于对照组(P＜0.05);治疗6周、12周后观察组Cr、Th17、Th17/Treg、BUN、TLR4、24 hUpro、NF-κB均低于对照组,Treg高于对照组(P＜0.05);观察组不良反应发生率4.84％与对照组11.29％比较,差异无统计学意义(P＞0.05).结论:益气养阴方联合他克莫司治疗NS患者可调控Th17/Treg免疫平衡,介导NF-κB信号转导通路,能有效缓解患者临床病症,改善肾功能,效果安全可靠.
Objective:To investigate the therapeutic effect of Yiqi Yangyin prescription combined with tacroli-mus in patients with nephrotic syndrome(NS).Methods:A total of 124 patients with NS in our hospital from June 2020 to June 2023 were randomly divided into two groups with 62 cases in each group.Both groups were given con-ventional treatment.On this basis,the control group was given tacrolimus,and the observation group was given Yiqi Yangyin prescription combined with tacrolimus for 12 weeks.Compare the clinical efficacy of the two groups,as well as TCM syndrome score,blood urea nitrogen(BUN),regulatory T cells(Treg),serum creatinine(Cr),24 h urinary protein(24 hUpro),helper T cell 17(Th17),Th17/Treg,peripheral blood nuclear factor-κB(NF-κB),Toll-like re-ceptor 4(TLR4)levels and adverse reactions before and after treatment.Results:The total effective rate of observa-tion group was 93.55％higher than that of control group 80.65％(P＜0.05).After 6 weeks and 12 weeks of treat-ment,the main disease,secondary disease and total score in observation group were lower than those in control group(P＜0.05).After 6 and 12 weeks of treatment,Cr,Th17,Th17/Treg,BUN,TLR4,24 hUpro and NF-κB in observa-tion groups were lower than those in control group,and Treg was higher than those in control group(P＜0.05).The incidence of adverse reactions in the observation group was 4.84％compared with 11.29％in the control group,and there was no significant difference(P＞0.05).Conclusion:Yiqi Yangyin prescription combined with tacrolimus in the treatment of NS patients can regulate Th17/Treg immune balance,mediate NF-κB signal transduction pathway,effec-tively alleviate clinical symptoms of patients,improve renal function,the effect is safe and reliable.
王利元;李晶;刘芳;吴悠;王静
武汉市中西医结合医院肾病内科,湖北 武汉 430030武汉市中西医结合医院肾病内科,湖北 武汉 430030武汉市中西医结合医院肾病内科,湖北 武汉 430030武汉市中西医结合医院肾病内科,湖北 武汉 430030武汉市中西医结合医院肾病内科,湖北 武汉 430030
医药卫生
肾病综合征益气养阴方他克莫司调节性T细胞Toll样受体4辅助性T细胞17外周血核因子-κB
Nephrotic syndromeYiqi Yangyin prescriptionTacrolimusRegulatory T cellsToll-like receptor 4Helper T cell 17Peripheral blood nuclear factor-κB
《陕西中医》 2026 (3)
355-359,5
湖北省科技计划项目(2021FFB6400)
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