通瘀煎化方配合雷公藤多苷对糖尿病肾病患者血液流变学及血清TGF-β_1、PDGF-BB、CTGF的影响
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摘要
目的观察通瘀煎化方配合雷公藤多苷对糖尿病肾病(DN)患者血流变及血清转化生长因子-β1(TGF-β1)、血小板衍化生长因子-BB(PDGF-BB)、结缔组织生长因子(CTGF)的影响。方法选取DN患者126例作为研究对象,按照随机数表法分为治疗组和对照组各63例,两组均给予健康教育、饮食、运动等基础干预,在此基础上对照组给予雷公藤多苷治疗,治疗组在对照组基础上配合通瘀煎化方治疗。观察两组中医证候积分、临床疗效、血糖、肾功能、血液流变学以及血清TGF-β1、PDGF-BB、CTGF水平情况。结果两组患者治疗后治疗组总有效率显著高于对照组,差异具有统计学意义(P <0. 05)。两组患者治疗后中医证候积分、血糖、肾功能、血液流变学以及血清TGF-β1、PDGF-BB、CTGF水平情况均优于本组治疗前(P <0. 05),且治疗组各指标水平均显著低于对照组(P <0. 05)。结论通瘀煎化方配合雷公藤多苷治疗DN患者,能够有效改善临床症状,降低血糖水平,改善血液流变学和TGF-β1、PDGF-BB、CTGF水平,同时增强肾功能,提高临床疗效。
Objective To observe the impacts of tongyu jianhua formula and tripterygium glycosides on hemorheology and serum transforming growth factor-beta 1( TGF-β1),platelet derived growth factor-BB( PDGF-BB) and connective tissue growth factor( CTGF) in the patients with diabetic nephropathy( DN). Methods A total of 126 DN patients were taken as the subjects. According to the random number table,they were divided into an treatment group and a control group,63 cases in each one. The basic intervention such as health education,diet and physical exercise was given in the two groups. Additionally,in the control group,tripterygium glycosides were used. In the treatment group,on the base of the treatment as the control group,tongyu jianhua formula was added. TCM symptom score,clinical effects,blood glucose,kidney function,hemorheology and serum TGF-β1,PDGF-BB and CTGF were observed in the two groups. Results The total effective rate in the treatment group was higher significantly than the control group after treatment,indicating the significant difference( P < 0. 05). After treatment,the results of TCM symptom score,clinical effects,blood glucose,kidney function,hemorheology and serum TGF-β1,PDGF-BB and CTGF were better than the results before treatment in the comparison of the same group( P < 0. 05). The level of every index in the treatment group was lower significantly than that in the control group( P < 0. 05). Conclusion The combined treatment with tongyu jianhua formula and tripterygium glycosides on hemorheology effectively relieves the clinical symptoms,reduces blood glucose,improves in the results of hemorheology and serum TGF-β1,PDGF-BB and CTGF,strengthens kidney functions and improves the clinical effects in the DN patients.
Objective To observe the impacts of tongyu jianhua formula and tripterygium glycosides on hemorheology and serum transforming growth factor-beta 1( TGF-β1),platelet derived growth factor-BB( PDGF-BB) and connective tissue growth factor( CTGF) in the patients with diabetic nephropathy( DN). Methods A total of 126 DN patients were taken as the subjects. According to the random number table,they were divided into an treatment group and a control group,63 cases in each one. The basic intervention such as health education,diet and physical exercise was given in the two groups. Additionally,in the control group,tripterygium glycosides were used. In the treatment group,on the base of the treatment as the control group,tongyu jianhua formula was added. TCM symptom score,clinical effects,blood glucose,kidney function,hemorheology and serum TGF-β1,PDGF-BB and CTGF were observed in the two groups. Results The total effective rate in the treatment group was higher significantly than the control group after treatment,indicating the significant difference( P < 0. 05). After treatment,the results of TCM symptom score,clinical effects,blood glucose,kidney function,hemorheology and serum TGF-β1,PDGF-BB and CTGF were better than the results before treatment in the comparison of the same group( P < 0. 05). The level of every index in the treatment group was lower significantly than that in the control group( P < 0. 05). Conclusion The combined treatment with tongyu jianhua formula and tripterygium glycosides on hemorheology effectively relieves the clinical symptoms,reduces blood glucose,improves in the results of hemorheology and serum TGF-β1,PDGF-BB and CTGF,strengthens kidney functions and improves the clinical effects in the DN patients.
引文
[1]高飞.黄葵胶囊联合雷公藤多苷片对比单用雷公藤多苷片治疗糖尿病肾病有效性和安全性的Meta分析[J].中国药房,2015,26(33):4675-4678.
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[8]刘洪.糖尿病肾病血液流变学的研究[J].现代医药卫生,2012,28(24):3696-3697.
[9]任玉军.黄芪注射液联合厄贝沙坦对早期DN患者微循环及CT-GF的影响[J].海南医学院学报,2016,22(22):2696-2698.
[10]张绿凤,秦林芳,宋纯东.雷公藤多甙治疗糖尿病肾病30例[J].中医临床研究,2015,7(19):63-64.
[11]孙志强,王世英,杨素霞,等.螺内酯联合百令胶囊对早期糖尿病肾病患者血清结缔组织生长因子和转化(下转第81页)生长因子β1表达的影响[J].新乡医学院学报,2013,30(9):727-729.
[12]刘珊,张明霞,杨晓芬,等.厄贝沙坦联合黄芪注射液对老年糖尿病肾病患者结缔组织生长因子的影响[J].中国老年学杂志,2015,35(1):108-110.
[13]蓝健姿,潘奇,陶庆,等.益肾活血颗粒对气虚血瘀型早期糖尿病肾病患者尿CTGF影响的临床研究[J].世界中医药,2016,11(1):79-82.
[14]王小强,刘刚.芪藤地黄颗粒联合雷公藤多甙片治疗Ⅳ期糖尿病肾病的研究[J].现代中西医结合杂志,2015,24(19):2060-2064.
[15]黄静,张继强,陈峥,等.雷公藤多苷治疗糖尿病肾病Ⅳ期患者疗效的系统评价[J].中国中药杂志,2015,40(15):3100-3109.
[16]富佳杰,朱斌,殷佳珍,等.益气补肾中药与雷公藤多苷联合缬沙坦治疗脾肾气虚型糖尿病肾病的随机对照研究[J].中国中西医结合肾病杂志,2015,16(10):881-883.
[17]龚保文,芮筱青,郑衍平.益气养阴活血法治疗早期糖尿病肾病血液流变学和血脂的临床研究[J].光明中医,2012,27(4):689-691.
[18]李志强,常红娟,孙仕润.自拟益气活血方治疗糖尿病肾病疗效以及对血液流变学和相关生化指标的影响[J].中国中医基础医学杂志,2013,19(6):657-659.
[19]韩茂志.补肾益气活血复方治疗糖尿病肾病临床研究[J].河南中医,2013,33(9):1460-1463.
[20]刘天易.益气活血汤联合雷公藤多苷治疗糖尿病肾病40例临床研究[J].中医临床研究,2015,7(29):14-16.
[2]江霞.雷公藤多苷联合替米沙坦治疗糖尿病肾病的疗效观察[J].现代药物与临床,2015,30(8):987-990.
[3]周培一.活血化瘀散结法治疗Ⅲ期糖尿病肾病气阴两虚夹瘀证临床研究[J].中医学报,2017,32(2):209-212.
[4]赖凌云,林善锬.糖尿病肾病的诊断[J].中华全科医师杂志,2004,3(1):10-11.
[5]中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案)[J].上海中医药杂志,2007,41(7):7-8.
[6]国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:31.
[7]张艳秋,张勉之.雷公藤多甙治疗糖尿病肾病的作用机制探讨[J].世界中西医结合杂志,2015,10(9):1329-1332.
[8]刘洪.糖尿病肾病血液流变学的研究[J].现代医药卫生,2012,28(24):3696-3697.
[9]任玉军.黄芪注射液联合厄贝沙坦对早期DN患者微循环及CT-GF的影响[J].海南医学院学报,2016,22(22):2696-2698.
[10]张绿凤,秦林芳,宋纯东.雷公藤多甙治疗糖尿病肾病30例[J].中医临床研究,2015,7(19):63-64.
[11]孙志强,王世英,杨素霞,等.螺内酯联合百令胶囊对早期糖尿病肾病患者血清结缔组织生长因子和转化(下转第81页)生长因子β1表达的影响[J].新乡医学院学报,2013,30(9):727-729.
[12]刘珊,张明霞,杨晓芬,等.厄贝沙坦联合黄芪注射液对老年糖尿病肾病患者结缔组织生长因子的影响[J].中国老年学杂志,2015,35(1):108-110.
[13]蓝健姿,潘奇,陶庆,等.益肾活血颗粒对气虚血瘀型早期糖尿病肾病患者尿CTGF影响的临床研究[J].世界中医药,2016,11(1):79-82.
[14]王小强,刘刚.芪藤地黄颗粒联合雷公藤多甙片治疗Ⅳ期糖尿病肾病的研究[J].现代中西医结合杂志,2015,24(19):2060-2064.
[15]黄静,张继强,陈峥,等.雷公藤多苷治疗糖尿病肾病Ⅳ期患者疗效的系统评价[J].中国中药杂志,2015,40(15):3100-3109.
[16]富佳杰,朱斌,殷佳珍,等.益气补肾中药与雷公藤多苷联合缬沙坦治疗脾肾气虚型糖尿病肾病的随机对照研究[J].中国中西医结合肾病杂志,2015,16(10):881-883.
[17]龚保文,芮筱青,郑衍平.益气养阴活血法治疗早期糖尿病肾病血液流变学和血脂的临床研究[J].光明中医,2012,27(4):689-691.
[18]李志强,常红娟,孙仕润.自拟益气活血方治疗糖尿病肾病疗效以及对血液流变学和相关生化指标的影响[J].中国中医基础医学杂志,2013,19(6):657-659.
[19]韩茂志.补肾益气活血复方治疗糖尿病肾病临床研究[J].河南中医,2013,33(9):1460-1463.
[20]刘天易.益气活血汤联合雷公藤多苷治疗糖尿病肾病40例临床研究[J].中医临床研究,2015,7(29):14-16.