健脾固肾化瘀组方联合雷公藤多苷片对临床期糖尿病肾病临床疗效及肾脏纤维化指标的影响
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摘要
目的:观察健脾固肾化瘀组方治疗临床期糖尿病肾病患者的临床疗效以及其对肾脏纤维化相关指标的影响。方法:选取2015年12月至2016年12月沧州中西医结合医院门诊及病房的临床期糖尿病肾病患者100例,随机平均分为2组,对照组50例患者在常规治疗的基础上加用雷公藤多苷片(20 mg/次,口服,3次/d)治疗,观察组50例患者在对照组治疗的基础上加用健脾固肾化瘀组方,1次/d,2组患者均以4周为1疗程,治疗3个疗程后统计2组患者的尿蛋白定量、肌酐(Scr)、胱抑素C(Cys C)、基质金属蛋白酶抑制剂-1(TIMP-1)、转化生长因子-β_1(TGF-β_1)、Ⅳ型胶原(CⅣ)指标以及临床疗效与不良反应。结果:观察组患者治疗后的尿蛋白、Scr、Cys C、TIMP-1、TGF-β_1、CⅣ明显低于治疗前与对照组治疗后(P <0. 05)。观察组患者治疗总有效率明显高于对照组(P <0. 05)。结论:健脾固肾组方联合雷公藤多苷片治疗临床期糖尿病肾病,能够有效降低尿蛋白,还可以有效改善血清肾功能指标与肾脏纤维化指标,具有良好的临床效果。
Objective: To observe clinical effects of Jianpi Gushen Huayu Formula on diabetic nephropathy in clinical stage and renal fibrosis related indexes. Methods: A total of 100 cases with clinical stage of diabetic nephropathy in outpatient department and ward from December 2015 to December 2016 were randomly divided into 2 groups,with 50 cases in each group. Control group treated with Tripterygium Glucosides dispersible tablets on the basis of routine treatment( oral administration,20 mg each time,3 times a day),while the treatment group was additionally treated with Jianpi Gushen Huayu Formula( 1 time a day),with 4 weeks as 1 course of treatment. Urinary protein,serum creatinine( Scr),Cystatin C( Cys C),tissue inhibitor of metalloproteinase-1( TIMP-1) and transforming growth factor β_1( TGF-β_1),type Ⅳ collagen( C Ⅳ) index,clinical curative effects and adverse reactions of 2 groups after treatment of 3 courses were calculated. Results: After treatment,urinary protein,Scr,Cys C,TIMP-1,TGF-β_1 and C Ⅳ in the treatment group were significantly lower than those before treatment and that of control group( P < 0. 05). The total effective rate of treatment group was significantly higher than that of control group( P < 0. 05). Conclusion: Jianpi Gushen formula combined with tripterygium glycosides tablets in the treatment of clinical stage of diabetic nephropathy,can effectively reduce the urinary protein,but also can effectively improve the serum indexes of renal function and renal fibrosis index,which has good clinical effects.
Objective: To observe clinical effects of Jianpi Gushen Huayu Formula on diabetic nephropathy in clinical stage and renal fibrosis related indexes. Methods: A total of 100 cases with clinical stage of diabetic nephropathy in outpatient department and ward from December 2015 to December 2016 were randomly divided into 2 groups,with 50 cases in each group. Control group treated with Tripterygium Glucosides dispersible tablets on the basis of routine treatment( oral administration,20 mg each time,3 times a day),while the treatment group was additionally treated with Jianpi Gushen Huayu Formula( 1 time a day),with 4 weeks as 1 course of treatment. Urinary protein,serum creatinine( Scr),Cystatin C( Cys C),tissue inhibitor of metalloproteinase-1( TIMP-1) and transforming growth factor β_1( TGF-β_1),type Ⅳ collagen( C Ⅳ) index,clinical curative effects and adverse reactions of 2 groups after treatment of 3 courses were calculated. Results: After treatment,urinary protein,Scr,Cys C,TIMP-1,TGF-β_1 and C Ⅳ in the treatment group were significantly lower than those before treatment and that of control group( P < 0. 05). The total effective rate of treatment group was significantly higher than that of control group( P < 0. 05). Conclusion: Jianpi Gushen formula combined with tripterygium glycosides tablets in the treatment of clinical stage of diabetic nephropathy,can effectively reduce the urinary protein,but also can effectively improve the serum indexes of renal function and renal fibrosis index,which has good clinical effects.
引文
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[6]吕树泉,张淑芳,苏秀海.糖尿病肾病的中医药研究近况[J].国际中医中药杂志,2016,38(9):862-864.
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[8]王海燕.阿托伐他汀治疗对2型糖尿病肾病患者肾纤维化程度及肾功能的影响[J].海军医学杂志,2016,37(6):563-565.
[9]陈顺仪,陈慧谊,朱丽梨,等.联合检测血清胱抑素C、β2微球蛋白和尿微量白蛋白对早期糖尿病肾病的诊断价值[J].实用医学杂志,2011,27(9):1678-1680.
[10]鲁剑梅.文建华治疗糖尿病肾病气阴两虚型临床经验[J].湖北中医杂志,2013,35(10):34-34.
[11]陈才铭,张苗苗,胡利明.大黄酸对肥胖糖尿病大鼠肾皮质PPARγ和TGF-β1表达的影响[J].中药材,2015,38(4):810-812.
[12]臧晓峰,谢湘林,吴轶川,等.西洋参二醇组皂苷对糖尿病肾病大鼠肾脏葡萄糖转运蛋白、尿β2-微球蛋白的影响[J].中国病理生理杂志,2008,24(6):1237-1239.
[13]黄晓东,沈楠,路倩,等.黄芪甲苷对糖尿病肾脏病变大鼠氧自由基代谢和转化生长因子β1mRNA表达的影响[J].吉林大学学报:医学版,2016,42(1):48-53.
[14]韩利梅,方敬爱,孙艳艳,等.芡实对糖尿病肾病大鼠肾组织中SOCS-3及IGF-1表达的影响[J].中国中西医结合肾病杂志,2014,15(9):767-769.
[2]Macisaac RJ,Ekinci EI,Jerums G.Markers of and risk factors for the development and progression of diabetic kidney disease[J].Am JKidney Dis,2014,63(2 Suppl 2):S39-62.
[3]董哲毅.2型糖尿病肾病与非糖尿病肾病鉴别诊断的临床方法学研究[M].北京:解放军医学院,2015:7.
[4]黎磊石,刘志红.中国肾脏病学[M].北京:人民军医出版社,2008:640-645.
[5]中华中医药学会糖尿病分会.糖尿病肾脏疾病中医诊疗标准[J].世界中西医结合杂志,2011,6(6):548-552.
[6]吕树泉,张淑芳,苏秀海.糖尿病肾病的中医药研究近况[J].国际中医中药杂志,2016,38(9):862-864.
[7]陈江华,程军.糖尿病肾病的治疗进展[J].现代实用医学,2014,26(8):923-925.
[8]王海燕.阿托伐他汀治疗对2型糖尿病肾病患者肾纤维化程度及肾功能的影响[J].海军医学杂志,2016,37(6):563-565.
[9]陈顺仪,陈慧谊,朱丽梨,等.联合检测血清胱抑素C、β2微球蛋白和尿微量白蛋白对早期糖尿病肾病的诊断价值[J].实用医学杂志,2011,27(9):1678-1680.
[10]鲁剑梅.文建华治疗糖尿病肾病气阴两虚型临床经验[J].湖北中医杂志,2013,35(10):34-34.
[11]陈才铭,张苗苗,胡利明.大黄酸对肥胖糖尿病大鼠肾皮质PPARγ和TGF-β1表达的影响[J].中药材,2015,38(4):810-812.
[12]臧晓峰,谢湘林,吴轶川,等.西洋参二醇组皂苷对糖尿病肾病大鼠肾脏葡萄糖转运蛋白、尿β2-微球蛋白的影响[J].中国病理生理杂志,2008,24(6):1237-1239.
[13]黄晓东,沈楠,路倩,等.黄芪甲苷对糖尿病肾脏病变大鼠氧自由基代谢和转化生长因子β1mRNA表达的影响[J].吉林大学学报:医学版,2016,42(1):48-53.
[14]韩利梅,方敬爱,孙艳艳,等.芡实对糖尿病肾病大鼠肾组织中SOCS-3及IGF-1表达的影响[J].中国中西医结合肾病杂志,2014,15(9):767-769.
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