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目的:探讨桂蓉汤联合一体化方案对慢性肾脏病3~4期患者临床效果及对细胞免疫的影响。方法:选取2010年3月至2013年4月在本院中西医结合科进行住院治疗的慢性肾脏病3~4期患者92例,随机分为桂蓉汤组(n=46)和常规组(n=46),常规组给予患者慢性肾衰竭一体化治疗方法,桂蓉汤组在常规治疗措施基础上给予桂蓉汤联合一体化方案。分别于治疗前和治疗2个月时,检测血肌酐(SCr)和血尿素氮(BUN),随访后计算出相应的e GFR值,利用流式细胞仪对T细胞亚群CD4+,CD8+,CD4+/CD8+进行检测,采用放射免疫法对细胞因子白细胞介素-2(IL-2)和IL-6进行检测。结果:桂蓉汤组和常规组分别有39例(84.8%)和41例(89.1%)完成了治疗。桂蓉汤组患者总有效率53.8%,显著高于常规组的17.1%,差异具有统计学意义(P<0.05);治疗2个月时,桂蓉汤组患者血SCr和BUN分别为(240.5±49.8)μmol·L-1和(9.8±3.9)mmol·L-1,均低于常规组,e GFR为(47.6±10.5)m L·(min·73 m2)-1,高于常规组,差异均具有统计学意义(P<0.05);桂蓉汤组患者CD4+和CD4+/CD8+分别为(34.2±6.7)%和(1.6±0.2),均高于常规组,CD8+为(21.5±4.7)%,低于常规组,差异均具有统计学意义(P<0.05),桂蓉汤组患者IL-2浓度为(19.6±6.3)mg·L-1,高于常规组,IL-6为(115.3±22.4)mg·L-1,低于常规组,差异均具有统计学意义(P<0.05)。结论:桂蓉汤联合一体化方案应用于慢性肾脏病3~4期临床效果确切,能够有效改善肾功能,提高患者细胞免疫水平,有助于提高患者生存质量。
Objective: To investigate the clinical effect and the effect of Gui Rong Decoction on the cellular immunity in patients with stage 3 ~ 4 chronic kidney disease. Methods: From March 2010 to April 2013, 92 patients with stage 3 ~ 4 chronic kidney disease who were hospitalized in the Department of Integrated Traditional Chinese and Western Medicine in our hospital were randomly divided into Guilongtang group (n = 46) and routine group n = 46). The routine group was given the integrated treatment of chronic renal failure. Gui Rong Tang group was given the Gui Rong Decoction integrated program based on the conventional treatment measures. Serum creatinine (SCr) and blood urea nitrogen (BUN) were measured before treatment and 2 months respectively. Corresponding eGFR values were calculated after follow-up. The T cell subsets CD4 +, CD8 +, CD4 + / CD8 +, and the levels of interleukin-2 (IL-2) and IL-6 were detected by radioimmunoassay. Results: Gui Rong Decoction group and conventional group were 39 cases (84.8%) and 41 cases (89.1%) were completed treatment. The total effective rate was 53.8% in Guirong Decoction group, which was significantly higher than 17.1% in conventional group (P <0.05). At 2 months, the SCr and BUN in Guirong Decoction group were (240.5 ± 49.8) μmol·L-1 and (9.8 ± 3.9) mmol·L-1, respectively, which were lower than those in the conventional group and eGFR was (47.6 ± 10.5) m L · (min · 73 m2) (P <0.05). The levels of CD4 + and CD4 + / CD8 + in patients with Guirong Decoction were (34.2 ± 6.7)% and (1.6 ± 0.2), respectively, which were significantly higher than those in the control group (P <0.05). The concentration of IL-2 in Guirong Decoction group was (19.6 ± 6.3) mg · L-1, which was higher than that in routine group and IL-6 was (115.3 ± 22.4) mg · L-1, respectively, which were significantly lower than those in the control group (P <0.05). Conclusion: The combination of Gui Rong Decoction combined with chemotherapy in stage 3 ~ 4 chronic kidney disease has definite clinical effect, which can effectively improve renal function, improve cellular immune level and improve quality of life of patients.