论文部分内容阅读
【目的】观察肾络安方对肥胖型早期糖尿病肾病的治疗效果并探讨其可能的机制。【方法】将68例肥胖型早期糖尿病肾病患者随机分为对照组和治疗组,每组各34例。2组均给予调整生活方式、饮食控制、降压、降糖、降脂等基础治疗,对照组同时给予厄贝沙坦口服,治疗组在对照组基础上加用肾络安方治疗。治疗16周后,比较2组治疗前后中医证候积分、体质量指数(BMI)、血液指标[血胱抑素C(Cys C)、血β2微球蛋白(β2-MG)、同型半胱氨酸(Hcy)、空腹血糖(FBG)]及尿液指标[尿单核细胞趋化蛋白-1/尿肌酐(UMCP-1/UCR)、正常T细胞活化后表达和分泌调节蛋白/尿肌酐(URANTES/UCR)、尿白蛋白—肌酐比值(UACR)、尿白蛋白排泄率(UAER)]的变化情况,并评价其疗效及安全性。【结果】1治疗过程中5例脱落,63例(治疗组32例、对照组31例)完成试验。2治疗组总有效率为90.6%,明显优于对照组的67.7%(P<0.05)。3治疗后,2组BMI均较治疗前明显降低(P<0.05)。4治疗后,治疗组的各项中医证候积分、血液指标(Cys C、β2-MG、Hcy、FBG)及尿液指标(UMCP-1/UCR、URANTES/UCR、UACR、UAER)均较本组治疗前及对照组治疗后明显降低(P<0.05)。5UMCP-1/UCR、URANTES/UCR、UACR、UAER相互呈正相关。6本试验中63例患者治疗前后血常规、大便常规、肝功能、心电图等安全性指标检测均未发现明显异常改变。【结论】肾络安方结合西药治疗肥胖型早期糖尿病肾病具有较好的疗效,可以减轻临床症状,降低BMI、Cys C、β2-MG、UACR、UAER水平,减少UMCP-1、URANTES排泄,其作用机制可能与肾络安方联合西药能抑制肾脏慢性炎症有关。
【Objective】 To observe the therapeutic effect of Shenluoanfang on obese early diabetic nephropathy and to explore its possible mechanism. 【Methods】 Sixty-eight obese patients with early diabetic nephropathy were randomly divided into control group and treatment group, 34 cases in each group. Both groups were given basic treatment such as lifestyle adjustment, diet control, blood pressure lowering, hypoglycemic, lipid-lowering and so on. The control group was treated with irbesartan orally. The treatment group was treated with Shenluoanfang on the basis of the control group. After 16 weeks of treatment, the TCM syndrome scores, body mass index (BMI), blood parameters [Cys C, β2-MG and homocysteine (Hcy, FBG) and urinary indicators (urine MCP-1 / UMCR-1 / UCR), expression and secretion of regulatory proteins / urinary creatinine ( URANTES / UCR), urinary albumin-creatinine ratio (UACR), urinary albumin excretion rate (UAER) were measured. The curative effect and safety were evaluated. 【Results】 5 cases of exfoliation during the course of treatment, 63 cases (treatment group, 32 cases, control group, 31 cases) to complete the test. 2 The total effective rate was 90.6% in the treatment group, which was significantly better than 67.7% in the control group (P <0.05). After treatment, the BMI in both groups was significantly lower than that before treatment (P <0.05). After treatment, the TCM syndrome scores, blood indexes (Cys C, β2-MG, Hcy, FBG) and urinary indicators (UMCP-1 / UCR, URANTES / UCR, UACR, UAER) Group before treatment and control group after treatment was significantly lower (P <0.05). 5UMCP-1 / UCR, URANTES / UCR, UACR, UAER were positively correlated with each other. 6 63 patients in this test before and after treatment of blood, stool, liver function, ECG and other safety indicators detected no significant abnormal changes were detected. 【Conclusion】 Shenluoanfang combined with western medicine has good curative effect on obese early diabetic nephropathy. It can relieve clinical symptoms, reduce the levels of BMI, Cys C, β2-MG, UACR and UAER, and decrease the excretion of UMCP-1 and URANTES. The mechanism of action may be related to the combination of Shenluoan Fang western medicine can inhibit chronic inflammation of the kidney.