| ObjectiveThis study based on nephritic syndrome with damp-heat and infection close relationship and the predecessors of the research basis about damp-heat syndrome. From the molecular biology level, observed the relevance of Primary nephrotic syndrome(PNS) Damp-heat syndrome and anti-inflammatory cytokines IL-4, IL-10, IL-13. It has a certain theoretical meaning and application value for Primary nephrotic syndrome Damp-heat syndrome to revealed evidence of Damp-heat syndrome substantial, part of the pathogenesis and mechanism of Chinese medicine about clearing away heat and dampness.MethodsThe main subject of a prospective, randomized, controlled clinical research methods, applied double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) and fluorescence detection quantitative PCR experiments, through the primary nephritic syndrome damp, non-damp patients is the main anti-inflammatory factor IL-4, IL-10, IL-13 levels detected using the SPSS software to analyze the data, systems analysis nephritic syndrome damp-heat and anti-inflammatory cytokines IL-4, IL-10, IL-13 Levels. Then through the primary nephritic syndrome patients by clearing away heat and damp of drug capsules for four weeks treated by Huang Kui capsule, observed the change of damp-heat and anti-inflammatory cytokines and evaluated clinical efficacy clearing away damp-heat drug-Huang Kui Capsule in treatment of PNS with damp-heat syndrome Clinical. Use of SPSS software to analyze the data, comprehensive analysis of damp- heat syndrome and related anti-inflammatory factors, and further analysis of the efficacy of Huang Kui Capsule-clearing away damp- heat drug in treatment of primary nephritic syndrome with damp-heat syndrome about the effect and mechanism.Result1. PNS with damp-heat experimental study of anti-inflammatory cytokinesSelect the kidney by the inclusion criteria 40 patients comprehensive damp-heat, non-damp-heat 20 patients, total 60 patients. The difference in the two groups in gender, age, pathological information was no significant difference(P>0.05), comparable. Double antibody sandwich enzyme-linked immunosorbent assay (ELISA) detection of anti-inflammatory factor IL-4, IL-10, IL-13 levels, quantitative PCR, peripheral blood monocyte cells of IL-13mRNA expression. The results are as follows:(1)PNS with damp-heat patients the level of IL-4 was 45.67±8.27 pg/ml, higher than patients of non-damp-heat IL-4-32.73±9.01 pg/ml, the difference was statistically significant(P<0.01).(2) PNS with damp patients the level of IL-10 was 29.97±4.22 pg/ml, higher than the patients of non-damp-heat IL-10-19.45±4.71 pg/ml, the difference was statistically significant(P<0.01).(3)PNS with damp patients the level of IL-13 was 25.92±6.94 pg/ml, higher than the patients of non-damp-heat IL-13-14.19±7.36 pg/ml, the difference was statistically significant(P<0.01).(4)PNS damp-heat patients peripheral blood monocyte cells of IL-13mRNA level of 0.65±0.11, significantly higher than non-damp-heat syndrome group IL-13mRNA level of 0.35±0.09, were statistically significant difference test (P<0.05).In comparison with PNS with damp-heat syndrome elevated levels of IL-13 was the same performance.(5)The group PNS with damp- heat syndrome scores and the level of IL-4, IL-10, IL-13 were correlative (P<0.01).2. Study the effect of Huang Kui Capsule on clinical and inflammatory cytokines in PNS with damp-heat symptoms(1)The impact of the symptomsBefore treatment the comparison between the study group and the control group symptom score was not statistically significant (P>0.05). The study group after treatment edema, sore throat, distension and nausea in chest and belly, dry mouth and not think to drink, bitter mouth, sticky mouth, yellow red urine, sticky stool symptoms improved significantly (P<0.05 or P<0.01). After treatment, there was statistically significant difference between the study group and the control group in clinical symptoms (P<0.05 or P<0.01). These clinical symptoms were oedema, swelling of skin boils, sore, sore throat, distension and nausea in chest and belly, bitter mouth, sticky mouth, yellow red urine, sticky stool. That improve the clinical symptoms, the study group was better than the control group.(2)The impact of laboratory testDamp-heat syndrome after treatment, the difference between the study group and the control group about activated partial thromboplastin time (APTT), fibrinogen (FIB), total cholesterol, triglyceride, low density lipoprotein and 24h urinary protein indicators was better than the control group (P<0.05 or P<0.01).(3)The impact of WBC total and hs-CRPDamp-heat syndrome after treatment, the study group and the control group of patients with white blood cell count and high-sensitivity C-reactive protein were decreased, by statistical analysis, and in comparison with before treatment was significant only in the study group (P<0.05 or P<0.01);after treatment between the two groups, study group, the total number of leukocytes, high sensitive C-reactive protein more significantly reduced the mean (P<0.05 or P<0.01).(4)The impact of inflammatory cytokines levelStudy group, IL-4 levels after treatment were significantly decreased (30.02±8.22pg/ml), in comparison with before (45.63±8.30pg/ml), was significant (P<0.01). The control group before and after treatment showed no significant difference (P>0.05). Between the two groups after treatment, the study group IL-4 level decreased more significantly than control group (P<0.01).Study group, IL-10 levels after treatment were significantly decreased (19.21+4.78pg/ml), in comparison with before (30.01+4.19 pg/ml), was significant (P<0.01). The control group before and after treatment showed no significant difference (P>0.05). Between the two groups after treatment, the study group IL-10 level decreased more significantly than control group (P<0.01).Study group, IL-13 levels after treatment were significantly decreased (14.11±7.20pg/ml), in comparison with before (25.94±6.91pg/ml), was significant (P<0.01). The control group before and after treatment showed no significant difference (P>0.05). Between the two groups after treatment, the study group IL-13 level decreased more significantly than control group (P<0.01).After drug treatment, the damp-heat syndrome group and in peripheral blood monocyte cells of IL-13mRNA expression level of 0.34±0.06, significantly lower than the control group, the expression of IL-13mRNA 0.60±0.09, after treatment was statistically significant(P<0.05).The IL-4,IL-10,IL-13 levels difference between before and after treatment for patients respectively correlated linearly with the syndrome integral difference of Damp-heat syndrome patient in the study group (P<0.05).Conclusion1.The study PNS with damp-heat syndrome inflammatory cytokines treated by Huang Kui capsule, the results showed that patients with primary nephritic syndrome damp-heat inflammatory cytokines level IL-4, IL-10, IL-13 increased abnormally; primary nephritic syndrome with damp-heat and increased levels of inflammatory cytokines have close relationship, symptoms of damp-heat syndrome scores and the level of IL-4, IL-10, IL-13 correlative.2. Used Huang Kui Capsule to treat of PNS with damp-heat syndrome the results showed that clearing away damp- heat drug Huang Kui Capsule adjusted down markedly inflammatory cytokines in PNS damp-heat syndrome patients with abnormal increase of inflammatory cytokines.3. Clearing away damp- heat drugs Huang Kui capsule can better alleviate the symptoms of patients with damp-heat and improve proteinuria in patients with renal comprehensive damp-heat, hyperlipidemia, and hypercoagulable state, etc., could improve the clinical efficacy of comprehensive damp-heat in PNS patient, reduced kidney integrated disease, the mechanism may be related to the anti-inflammatory drug as the role of the antigen clearance.
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