The Clinical Effect Observation Of Centella Asiatica Combined With Immunosuppressive Therapy On Treatment And Prevention Of Tubulointerstitial Tibrosis In Renal Allograft

Background and Objective: The main factor that influence long-term survival of renal allograft is chronic rejection,whose histopathologic manifestations are progressive glomerular sclerosis,artery vascular fibrous intimal thickening,tubular atrophy and tubulointerstitial tibrosis.Among those,the chronic rejection based on tubulointerstitial tibrosis is above 53%.It is a worldwide challenge that renal allograft is always failed by chronic rejection based on tubulointerstitial tibrosis.This topic will make a meaningful study on this challenge.By comparing the effect of traditional treatment based on triply immunosuppressive therapy(Cs A/ FK506 + MMF + Pred)and centella asiatica combination therapy to tubulointerstitial tibrosis of renal allograft,to explore the effects of centella asiatica to tubulointerstitial tibrosis.Then give further study on the meaning of centella asiatica to treat and prevent chronic rejection.Try to provide a practical method and optimally therapeutic measures in preventing and treating chronic rejection.Methods : Sixty cases of patients whose renal pathological diagnosis are tubulointerstitial tibrosis from the first affiliated hospital of Henan university of traditional chinese medicine from June2014 to December2016 were selected in this study,and control group(30 cases).Patients of control group were given conventional medicine based on immunosuppressive therapy,while patients of test group were given conventional medicine combined with centella asiatica particles.The treatment course was 6 months.The laboratory test including blood routine,blood lipids,blood glucose,liver function(ALT,AST),as well as urine beta 2-MG,urine alpha 1-MG,24-hour urinary protein quantity,kidney function(BUN?Scr?GRF?Ccr)and renal color ultrasound before treating and after treating in 1 month.And the renal pathologies by renipuncture with colour doppler guide after treating 6 months were compared,too.Results:(1)The difference was statistically significant(P<0.05),suggesting the efficacy of test group was superior to control group.(2)The laboratory indexes including blood routine,blood lipids,blood glucose and liver function after treatment in both groups all the time in 1-month,3-month and 6-month reduced,but there was no statistically significant all the time(P>0.05).(3)Urine beta 2-MG,urine alpha 1-MG,24-hour urinary protein quantity,and the indexes of kidney function after treatment in test group all the time in 1-month,3-month and 6-month reduced.Meanwhile,the difference between the two groups all the time was statistically significant(P<0.05).Suggesting the treatment of test group on controlling CR was superior to control group.(4)The renal pathology of both groups were improved at 6-month treatment,and the difference was statistically significant(P < 0.05),suggesting the treatment of test group on controlling CR was superior to control group.Conclusion: Centella asiatica particles with immune inhibitors may reduce renal tubular interstitial injury,renal interstitial fibrosis resistance;Improve graft function,decrease the urine protein;Patients with reduced cholesterol,the level of platelet function;Can improve the transplant renal blood circulation,increase blood flow perfusion,reduce pipe resistance index,are a good complement graft TIF a variety of treatments,and no obvious adverse reaction occurred,security is good.