益气养阴通络方对早期糖尿病肾病微炎症状态的影响
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摘要
目的探讨益气养阴通络方对早期糖尿病肾病微炎症状态的影响。方法将患者随机分2组各39例,对照组给予常规基础治疗,治疗组在对照组基础上加用益气养阴通络方,12周后比较2组C反应蛋白(CRP)、肿瘤坏死因子(TNF?α)、尿白蛋白排泄率(UAE)及临床疗效、中医证候积分、血压、血糖、尿素氮(BUN)、肌酐(Scr)等指标变化。结果治疗组总有效率及中医证候积分改善情况优于对照组(P<0.05);与治疗前相比,2组治疗后UAE、CRP、TNF?α水平均降低(P<0.05～0.01),治疗组改善幅度优于对照组(P<0.05);观察过程均未出现肾功能恶化。结论益气养阴通络方能改善早期糖尿病肾病患者的症状,降低炎症因子CRP、TNF?α水平,减少蛋白尿,对早期糖尿病肾病的微炎症状态有明显的干预作用,从而延缓了糖尿病肾病进展。
OBJECTIVE To explore the effect of Yiqi Yangyin Tongluo formula on micro inflammatory state of patients with early diabetic nephropathy.METHODS 78 patients were randomly divided into two groups with 39 patients in each group.The control group was given conventional basic treatment,and the treatment group was treated with Yiqi Yangyin Tongluo formula on the basis of the control group.After 12 weeks,the changes of C-reactive protein(CRP),tumor necrosis factor(TNF?α),urinary albumin excretion rate(UAE)and clinical efficacy,TCM syndrome score,blood pressure,blood glucose,urea nitrogen(BUN),creatinine(Scr)and other indicators in two groups were compared.RESULTS The total effective rate and TCM syndrome score improvement in the treatment group were better than those in the control group(P<0.05).Compared with pre-treatment,the levels of UAE,CRP and TNF?αin the two groups were lower(P<0.05,P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.05).No renal deterioration appeared during the observation process.CONCLUSION Yiqi Yangyin Tongluo formula can improve the symptoms of patients with early diabetic nephropathy,reduce the levels of inflammatory factors CRP,TNF?α,reduce proteinuria,and significantly interfere with the micro inflammation of early diabetic nephropathy,thus delaying the progression of diabetic nephropathy.
OBJECTIVE To explore the effect of Yiqi Yangyin Tongluo formula on micro inflammatory state of patients with early diabetic nephropathy.METHODS 78 patients were randomly divided into two groups with 39 patients in each group.The control group was given conventional basic treatment,and the treatment group was treated with Yiqi Yangyin Tongluo formula on the basis of the control group.After 12 weeks,the changes of C-reactive protein(CRP),tumor necrosis factor(TNF?α),urinary albumin excretion rate(UAE)and clinical efficacy,TCM syndrome score,blood pressure,blood glucose,urea nitrogen(BUN),creatinine(Scr)and other indicators in two groups were compared.RESULTS The total effective rate and TCM syndrome score improvement in the treatment group were better than those in the control group(P<0.05).Compared with pre-treatment,the levels of UAE,CRP and TNF?αin the two groups were lower(P<0.05,P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.05).No renal deterioration appeared during the observation process.CONCLUSION Yiqi Yangyin Tongluo formula can improve the symptoms of patients with early diabetic nephropathy,reduce the levels of inflammatory factors CRP,TNF?α,reduce proteinuria,and significantly interfere with the micro inflammation of early diabetic nephropathy,thus delaying the progression of diabetic nephropathy.
引文
[1]仲海峰,周永华,申宜梅.丹红注射液联合缬沙坦对糖尿病肾病早期患者微炎症因子的干预作用[J].中外医学研究,2015,13(36):49-51.
[2]宇汝翠,陆智慧,李平.益气养阴通络方治疗早期糖尿病肾病的临床研究[J].南京中医药大学学报,2017,33(1):101-103.
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[7]FATTON B,AMBLARD J,DEBODINANCE P,et al.Transvaginal repair of genital prolapse:preliminary results of a new tension-free vaginal mesh(Prolift technique)a case series multicentric study[J].Int J Pelvic Floor Dysfunct,2007,18(7):743-752.
[8]NAVARRO JF,MORA C,MACA M,et al.Inflammatory parameters are independently associated with urinary albumin excretion in type 2diabetes mellitus[J].Am J Kidney Dis,2003,42(1):53-61.
[9]马广蕊,金秀平.不同病程2型糖尿病患者血清C反应蛋白水平的比较[J].中国全科医学,2011,14(5):494-496.
[10]ABRAHAMIAN H,ENDLER G,EXNER M,et al.Association of low grade inflammation with nephropathy in type 2diabetic patients:role of elevated CRP levels and 2different gene-polymorphisms of proinflammatory eytokines[J].Exp Clin Endocrinol Diabetes,2007,115(1):38-41.
[11]NAVARRO JF,MORA C,MUROS M,et al.Urinary tumour necrosis factor-alpha excretion independently correlates with clinical markers of glomerular and tubulointerstitial injury in type 2diabetic patients[J].Nephrol Dial Transplant,2006,21(12):3428-3434.
[12]赵佶.圣济总录[M].北京:人民卫生出版社,1962:496-497.
[13]李晓燕,董姝,魏滨,等.六味地黄汤中药成分-靶标-疾病网络分析及效应机制预测[J].中国实验方剂学杂志,2017,23(5):189-195.
[14]刘培,段金廒,白钢,等.用于妇科血瘀证原发性痛经的四物汤类方主要活性成分网络药理学分析[J].中国中药杂志,2014,39(1):113-120.
[2]宇汝翠,陆智慧,李平.益气养阴通络方治疗早期糖尿病肾病的临床研究[J].南京中医药大学学报,2017,33(1):101-103.
[3]中华医学会糖尿病分会微血管并发症学组.糖尿病肾病防治专家共识[J].中华糖尿病杂志,2014,6(11):792-801.
[4]中华中医药学会.糖尿病肾病中医防治指南[J].中国中医药现代远程教育,2011,9(4):151-153.
[5]中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[6]金希萍,胡友莹.糖尿病肾病患者炎症相关因子水平及临床意义[J].安徽医药,2011,15(10):1260-1261.
[7]FATTON B,AMBLARD J,DEBODINANCE P,et al.Transvaginal repair of genital prolapse:preliminary results of a new tension-free vaginal mesh(Prolift technique)a case series multicentric study[J].Int J Pelvic Floor Dysfunct,2007,18(7):743-752.
[8]NAVARRO JF,MORA C,MACA M,et al.Inflammatory parameters are independently associated with urinary albumin excretion in type 2diabetes mellitus[J].Am J Kidney Dis,2003,42(1):53-61.
[9]马广蕊,金秀平.不同病程2型糖尿病患者血清C反应蛋白水平的比较[J].中国全科医学,2011,14(5):494-496.
[10]ABRAHAMIAN H,ENDLER G,EXNER M,et al.Association of low grade inflammation with nephropathy in type 2diabetic patients:role of elevated CRP levels and 2different gene-polymorphisms of proinflammatory eytokines[J].Exp Clin Endocrinol Diabetes,2007,115(1):38-41.
[11]NAVARRO JF,MORA C,MUROS M,et al.Urinary tumour necrosis factor-alpha excretion independently correlates with clinical markers of glomerular and tubulointerstitial injury in type 2diabetic patients[J].Nephrol Dial Transplant,2006,21(12):3428-3434.
[12]赵佶.圣济总录[M].北京:人民卫生出版社,1962:496-497.
[13]李晓燕,董姝,魏滨,等.六味地黄汤中药成分-靶标-疾病网络分析及效应机制预测[J].中国实验方剂学杂志,2017,23(5):189-195.
[14]刘培,段金廒,白钢,等.用于妇科血瘀证原发性痛经的四物汤类方主要活性成分网络药理学分析[J].中国中药杂志,2014,39(1):113-120.