主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2017, Vol. 40 ›› Issue (9): 777-782.doi: 10.3969/j.issn.1006-2157.2017.09.012

• 临床研究 • 上一篇    下一篇

清热化湿祛瘀法对慢性肾衰竭湿热证患者瘦素介导的JAK/STAT信号通路的影响*

王东,王亿平#,余敏,胡顺金,吕勇,程皖,刘家生,魏玲,金华   

  1. 安徽中医药大学第一附属医院 安徽 230031
  • 收稿日期:2017-04-10 出版日期:2017-09-10 发布日期:2017-09-10
  • 通讯作者: 王亿平,男,硕士,教授,博士生导师,研究方向:中西医结合治疗慢性肾脏病,E-mail:Wypwyp54@aliyun.com
  • 作者简介:王东,男,博士,主治医师
  • 基金资助:
    *国家自然科学基金资助项目(No.81473673,No.81403372),安徽省自然科学基金资助项目(No.1508085MH198)

Influence of heat-clearing dampness-resolving stasis-dispelling therapy on JAK/STAT signaling pathway mediated by Leptin in patients with chronic renal failure-damp-heat pattern*

WANG Dong, WANG Yiping#, YU Min, HU Shunjin, LYU Yong, CHENG Wan, LIU Jiasheng, WEI Ling, JIN Hua   

  1. First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui 230031, China
  • Received:2017-04-10 Online:2017-09-10 Published:2017-09-10
  • Supported by:
    National Natural Science Foundation of China (No. 81473673, No. 81403372), Natural Science Foundation of Anhui Province (No. 1508085MH198)

摘要: 目的 观察清热化湿祛瘀中药清肾颗粒对慢性肾衰竭(CRF)湿热证患者血清瘦素(Leptin)、Janus激酶/信号转导与转录活化因子(JAK/STAT)信号通路中Janus激酶2(JAK2)蛋白及信号转导和转录激活因子3(STAT3)蛋白表达的影响,探讨清肾颗粒治疗CRF患者的作用机制。方法 68例CRF湿热证患者,随机数字表法分为治疗组和对照组,每组34例,实际完成60例,治疗组29例,对照组31例。治疗组及对照组给予西医基础治疗,治疗组加用清肾颗粒,每日3次,每次1袋,疗程均为12周。观察2组患者临床疗效、治疗前后血肌酐(Scr)、肾小球滤过率估算值(eGFR)以及血清Leptin、JAK2蛋白、STAT3蛋白变化情况。结果 治疗组临床疗效和中医证候疗效总有效率为86.21%(25/29)和82.76%(24/29),优于对照组的58.06%(18/31)和54.84%(17/31),差异有统计学意义(P<0.05)。与本组治疗前比较,治疗后治疗组Scr水平明显下降(P<0.01),eGFR水平明显升高(P<0.01),且优于对照组同期(P<0.05)。与本组治疗前比较,治疗后治疗组Leptin、JAK2、STAT3水平均明显降低(P<0.01),且均优于对照组同期(P<0.05或P<0.01)。结论 清肾颗粒可降低CRF湿热证患者血清Leptin、JAK2蛋白及STAT3蛋白水平,抑制瘦素介导的JAK/STAT信号通路的活化,进而改善CRF湿热证患者临床症状和肾功能。

关键词: 慢性肾衰竭, 湿热证, 清热化湿祛瘀法, 清肾颗粒, 血清瘦素, Janus激酶2, 信号转导和转录激活因子3

Abstract: Objective To observe the influences of Qingshen (Kidney-Clearing) Granules, with effects of clearing heat, resolving dampness and dispelling stasis, on expressions of Janus-activated kinase 2 (JAK2) and signal transducers and activator of transcriptions 3 (STAT3) in Janus-activated kinase-signaltransducer and activator of transcription (JAK/STAT) signaling pathway mediated by Leptin in patients with chronic renal failure (CRF)-damp-heat pattern, and investigate the mechanism of Qingshen Granules in treatment of CRF. Methods The patients with CRF-damp-heat pattern (n=68) were randomly divided into treatment group and control group (each n=34). The study was completed actually in 60 patients, and 29 in treatment group and 31 in control group. All 2 groups were given basic treatment of Western medicine, and treatment group was additionally given Qingshen Granules (thrice daily and 1 bas every time) for 12 weeks. The clinical efficacy and changes of serum creatinine (SCr), estimated glomerular filtration rate (eGFR), serum Leptin, JAK2 and STAT3 were observed in 2 groups. Results The clinical efficacy was 86.21% (25/29) and total effective rate of TCM patterns was 82.76% (24/29) in treatment group, and 58.06% (18/31) and 54.84% (17/31) in control group (P<0.05). After treatment, the level of SCr decreased significantly (P<0.01) and level of GFR increased significantly (P<0.01) in treatment group compared with those before treatment, which were superior to those in control group at the same term (P<0.05). After treatment, the level of Leptin, and expressions of JAK2 and STAT3 decreased significantly (P<0.01) in treatment group compared with those before treatment, which were superior to those in control group at the same term (P<0.05 or P<0.01). Conclusion Qingshen Granules can reduce the level of Leptin and expressions of JAK2 and STAT3, inhibit the activation of JAK/STAT signaling pathway mediated by Leptin, relieve clinical symptoms and improve kidney function in patients with CRF-damp-heat pattern.

Key words: chronic renal failure, damp-heat pattern, heat-clearing dampness-resolving stasis-dispelling therapy, Qingshen (Kidney-Clearing) Granules, serum Leptin, Janus-activated kinase 2, signal transducers and activator of transcriptions 3

中图分类号: 

  • R269.25