CAJ | 학술논문

目的：研究加味当归补血汤对 IgA 肾病患者的抑制细胞因子聚集及延缓肾脏纤维化的保护作用。方法将经过肾活检证实的 IgA 肾病患者进行随机分组治疗，对照组仅使用基础治疗，治疗组在基础治疗的基础上加用加味当归补血汤。在治疗终点应用统计学方法分析2组患者血、尿细胞因子及纤维化相关指标，并进行组间疗效差异的比较。结果治疗组和对照组均可减少24 h尿蛋白水平，治疗组由治疗前的（5．78±1．10）g 下降至（1．25±0．67）g，而对照组由（5．25±1.21） g 下降至（2．09±0．89）g。同时具有调节患者细胞因子和纤维化相关指标如单核细胞趋化蛋白-1（MCP-1）、巨噬细胞移动抑制因子（MIF）、转化生长因子-β1（TGF-β1）、透明质酸酶（HA）、层粘连蛋白（LN）、胶原Ⅳ（Col-Ⅳ）、Ⅲ型前胶原 N 端肽 P（PⅢNP）等的作用疗效显著，治疗前后自身对照改善均具有统计学意义（P ＜0．05）。2组治疗后以上数据的组间比较，除尿液 LN 外组间比较均有统计学意义，分析其在 IgA 肾病肾脏纤维化的意义表明治疗组的疗效优于对照组。结论中药和西药治疗均对 IgA 肾病具有较好的抑制细胞因子聚集及延缓肾脏纤维化的保护作用，配合中药加味当归补血汤治疗可以明显提高临床疗效。
목적：연구가미당귀보혈탕대 IgA 신병환자적억제세포인자취집급연완신장섬유화적보호작용。방법장경과신활검증실적 IgA 신병환자진행수궤분조치료，대조조부사용기출치료，치료조재기출치료적기출상가용가미당귀보혈탕。재치료종점응용통계학방법분석2조환자혈、뇨세포인자급섬유화상관지표，병진행조간료효차이적비교。결과치료조화대조조균가감소24 h뇨단백수평，치료조유치료전적（5．78±1．10）g 하강지（1．25±0．67）g，이대조조유（5．25±1.21） g 하강지（2．09±0．89）g。동시구유조절환자세포인자화섬유화상관지표여단핵세포추화단백-1（MCP-1）、거서세포이동억제인자（MIF）、전화생장인자-β1（TGF-β1）、투명질산매（HA）、층점련단백（LN）、효원Ⅳ（Col-Ⅳ）、Ⅲ형전효원 N 단태 P（PⅢNP）등적작용료효현저，치료전후자신대조개선균구유통계학의의（P ＜0．05）。2조치료후이상수거적조간비교，제뇨액 LN 외조간비교균유통계학의의，분석기재 IgA 신병신장섬유화적의의표명치료조적료효우우대조조。결론중약화서약치료균대 IgA 신병구유교호적억제세포인자취집급연완신장섬유화적보호작용，배합중약가미당귀보혈탕치료가이명현제고림상료효。
Objective To investigate the effects of supplemented Danggui Buxue Tang (Chinese angelica blood-tonifying decoction)on inhibition of cytokine congregation and kidney cirrhosis in patients with IgA glomerulonephritis.Methods Histopathologically confirmed IgA grlomerulonephritic patients were ran-domly divided into two groups.Both groups received routine treatment while treatment group was given an extra supplemented Danggui Buxue Tang.Outcome measures were urine and blood cytokines and fibrosis related parameters to compare the differences between groups.Results 24h urine protein level was both reduced in treatment group (from 5.78 ±1.10 g to 1.25 ±0.67 g)and control group (from 5.25 ±1.21 g to 2.09 ±0.89 g).Cytokines and fibrosis related parameters including MCP-1,MIF,TGF-β1,HA, LN,Col-IV,and PIIINP were all significantly improved after intervention in both groups respectively (P<0.05).The difference between two groups was significant in all factors except LN.Conclusion Com-bined treatment of with conventional and Chinese medicine is effective for IgA glomerulonephritis in terms of inhibiting cytokine aggregation and delay kidney cirrhosis.Adding supplemented Danggui Buxue Tang according to TCMpattern identification seems to improve effectiveness significantly.