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投稿时间：2024-10-31 网络发布日期：2025-07-21
投稿时间：2024-10-31 网络发布日期：2025-07-21
中文摘要: 目的 探讨在常规西药治疗基础上加用程氏萆薢分清饮治疗对湿浊瘀阻型尿酸性肾病（UAN）患者外周血单个核细胞（PBMCs）中核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）炎症小体的影响。方法 选取2020年1月至2023年12月于南京中医药大学南通附属医院确诊的74例湿浊瘀阻型UAN患者，随机分为观察组和对照组各37例，剔除脱落病例，最终两组各纳入34例。对照组给予非布司他口服降尿酸治疗，观察组在对照组的基础上加用程氏萆薢分清饮口服，4周后比较两组PBMCs中NLRP3炎症小体关键因子（NLRP3、Caspase-1）表达、治疗总有效率、肾功能指标［血清尿酸（UA）、尿素氮（BUN）、肌酐（SCr）、胱抑素C（CysC）］，以及血清炎症因子［白介素（IL）-1β、IL-18］。结果观察组总有效率高于对照组（91.18% vs 70.59%，χ2=4.660，P=0.031）。观察组治疗后PBMCs中NLRP3和Caspase-1mRNA及蛋白表达均低于对照组（P<0.05），且血清BUN、Cys-C及IL-1β、IL-18水平低于对照组（P<0.05）。结论 程氏萆薢分清饮联合非布司他治疗湿浊瘀阻型UAN，能有效抑制患者PBMCs中NLRP3炎症小体的表达，并改善患者肾功能及炎症因子水平，疗效优于单独使用非布司他组。
中文关键词: 尿酸性肾病 湿浊瘀阻型 程氏萆薢分清饮 NLRP3 炎症小体 半胱氨酸天冬氨酸蛋白酶 1 外周血单 个核细胞 肾功能
Abstract:Objective To investigate the effect of Cheng's Bixie Fenqing Decoction combined with conventional Western medicine on the NOD-like receptor thermal protein domain associated protein 3（NLRP3）inflammasome in peripheral blood mononuclear cells（PBMCs）of patients with uric acid nephropathy（UAN）of the dampness-turbidity and blood stasis syndrome type. Methods A total of 74 patients diagnosed with damp-turbidity and blood stasis syndrome UAN at Nantong Hospital Affiliated to Nanjing University of Chinese Medicine from January 2020 to December 2023 were randomly divided into an observation group（n=37）and a control group（n=37）. After excluding dropouts，34 cases were finally included in each group. The control group received febuxostat for uric acid-lowering therapy，while the observation group received Cheng,s Bixie Fenqing Decoction in addition to febuxostat. After 4 weeks， the expression of key NLRP3 inflammasome components（NLRP3，Caspase-1）in PBMCs，total treatment efficacy，renal function indicators［serum uric acid（UA），blood urea nitrogen（BUN），serum creatinine（SCr），cystatin C （Cys C）］，and serum inflammatory cytokines［interleukin（IL）-1β, IL-18］were compared between the two groups. Results The total efficacy rate in the observation group was higher than that in the control group（91.18% vs 70.59%， χ2=4.660，P=0.031）. After treatment，the mRNA and protein expression levels of NLRP3 and Caspase-1 in PBMCs were lower in the observation group than in the control group（P<0.05）. Additionally ，serum levels of BUN，Cys C， IL-1β, and IL-18 were lower in the observation group（P<0.05）.Conclusion Cheng's Bixie Fenqing Decoction combined with febuxostat in the treatment of damp-turbidity and blood stasis syndrome UAN can effectively inhibit the expression of the NLRP3 inflammasome in PBMCs，improve renal function，and reduce inflammatory cytokine levels， demonstrating superior efficacy compared to febuxostat alone.
keywords: Uric acid nephropathy Damp turbidity and blood stasis type Cheng's Bixie Fenqing Decoction NLRP3 inflammasome Caspase⁃ 1 Peripheral blood mononuclear cells Renal function
文章编号： 中图分类号：R541.7 文献标志码：B
基金项目:江苏省中医药管理局面上项目（2023061）；江苏省第四批省名老中医药专家传承工作室建设项目（苏中医科教〔2021〕7号）； 江苏省第三批老中医药专家学术经验继承项目（苏中医科教〔2019〕8号）；南通市自然科学基金青年基金项目（JC2023058）； 南京市卫生健康委员会（ZYQ20066）；南通市卫健委面上项目（MS2022039）；南通市科技局民生科技计划（MSZ21016）
附件
| Author Name | Affiliation |
| LI Xiaoqian*，GU Yongqing，REN Lihong，LI Wei，XUE Li，QU Wei，FANG Qijun | *Nantong Hospital Affiliated to Nanjing University of Chinese Medcine,Nantong,Jiangsu 226001,China |
引用文本：
李晓倩,顾勇清,任丽红,等.程氏萆薢分清饮对湿浊瘀阻型尿酸性肾病患者外周血单个核细胞NLRP3炎症小体表达影响[J].中国临床研究,2025,38(7):1100-1104.
李晓倩,顾勇清,任丽红,等.程氏萆薢分清饮对湿浊瘀阻型尿酸性肾病患者外周血单个核细胞NLRP3炎症小体表达影响[J].中国临床研究,2025,38(7):1100-1104.