参芪水煎液防治顺铂化疗所致肾损伤临床研究

Clinical Study on the Prevention and Treatment of Renal Injury Induced by Cisplatin Chemotherapy with Shenqi Decoction

  • 摘要: 目的  观察参芪水煎液在防治顺铂化疗所致肾损伤方面的作用,探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在早期肾损伤评估中的意义。方法  采用随机对照的设计方案,入选60例确诊为肺癌患者,随机分为干预组及对照组各30例,2组患者予含顺铂方案化疗,干预组在化疗同时加用参芪水煎液口服。在化疗前、化疗第2疗程及第4疗程分别收集2组患者临床资料,包括血肌酐(Scr)、尿蛋白(UTP),尿-β2微球蛋白(β2-MG)、尿视黄醇结合蛋白(RBP)及NGAL含量,采用ELISA法统一检测,进行统计分析。结果  与化疗前相比,2组患者肾损伤指标NGAL、Scr、UTP、β2-MG及RBP水平在第4疗程均较化疗前升高(P < 0.01),与干预组相比,对照组升高幅度更明显(P < 0.01);在化疗周期较短的第2疗程,Scr、UTP、β2-MG及RBP水平与化疗前比较没有显著变化(P>0.05),而血NGAL在化疗第2疗程较化疗前均已显著升高,且在第4疗程呈明显上升趋势(P < 0.01),干预组低于对照组(P < 0.01)。结论  参芪水煎液能改善患者Scr、UTP、β2 -MG、RBP及NGAL指标的表达,进而防治顺铂化疗所致肾损伤;且NGAL检测在评价早期肾损伤方面具有优势。

     

    Abstract: OBJECTIVE  To observe the effect of the Buqi formula of Shenqi decoction in the prevention and treatment of kidney damage caused by cisplatin chemotherapy, and to explore the significance of neutrophile granulocyte gelatinase-related lipid (NGAL) carrier protein in the early stage of renal injury assessment.METHODS  Using a random control design scheme, 60 patients with lung cancer were randomly divided into the intervention group and the control group, 30 cases for each group. The intervention group was given cisplatin-containing chemotherapy, and the intervention group was given Shenqi decoction in addition to chemotherapy. Before chemotherapy, during the second and fourth courses. Clinical data, including serum creatinine (Scr), urine protein (UTP), urine β2 microglobulin (β2 -MG), urethra retinol-binding protein (RBP) and NGAL content were collected using ELISA.RESULTS  The nephropathy indicators NGAL, Scr, UTP, β2 -MG, and RBP were increased in the fourth course than that before chemotherapy treatment (P < 0.01), among which the control group increased more obviously. In terms of Scr, UTP, β2 -MG, and RBP levels, there were no significant difference in both groups before and after treating two courses (P>0.05). The blood NGAL level increased significantly in the second course and rose more obviously in the fourth course (P < 0.01), which was lower in the intervention group than that of the control group (P < 0.01).CONCLUSION  Buqi Formula of Shenqi decoction can improve the expression of Scr, UTP, β2 -MG, RBP and NGAL, thus preventing and treating renal injury induced by cisplatin chemotherapy. Besides, NGAL detection has advantages in estimating early renal injury.

     

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