大补元煎加味联合氯沙坦治疗气阴两虚夹瘀证糖尿病肾病疗效及对蛋白尿、炎症因子的影响  

Curative Effect of Mmodified Dabuyuan Decoction Combined with Losartan on Diabetic Nephropathy of Qi-Yin Deficiency and Blood Stasis Syndrome and Its Influences on Proteinuria and Inflammatory Factors

作　　者：贾菲 朱艺欣 刘红梅 JIA Fei;ZHU Yixin;LIU Hongmei(Department of Pharmacy,the Affiliated Hospital of Yan'an University,Yan'an Shaanxi,721600,China;Department of Internal Medicine,the Affiliated Hanjiang Hospital of Xi'an Medical University,Hanzhong Shaanxi 723003,China)

机构地区：[1]延安大学附属医院药剂科,陕西延安721600 [2]西安医学院附属汉江医院内一科,陕西汉中723003

出　　处：《四川中医》2022年第2期134-138,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：陕西省重点研发计划项目(编号:2017SF-019)

摘　　要：目的:探讨大补元煎加味联合氯沙坦治疗气阴两虚夹瘀证糖尿病肾病疗效及对蛋白尿及炎症因子的影响。方法:选取2019年3月~2020年6月收治DN患者92例,采用随机数字法分为试验组与对照组,各46例。对照组在基础治疗上服用氯沙坦,试验组在对照组基础上加用大补元煎加味,比较两组治疗效果、中医证候积分、血糖指标[空腹血糖(FPG)、饭后2h血糖(PBG)、糖化血红蛋白(HbA1C)]水平、肾功能指标[血清肌酐(SCr)、24h尿总蛋白、尿β2-微球蛋白(β2-MG)、血尿素氮(BUN)]水平、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平、内皮功能指标[内皮素-1(ET-1)、血管内皮生长因子(VEGF)、一氧化氮(NO)]水平、不良反应情况。结果:治疗后,试验组治疗总有效率为91.30%高于对照组73.91%(P<0.05);试验组患者各项中医证候积分低于对照组(P<0.05);试验组患者FPG、PBG、HbA1C低于对照组(P<0.05);试验组患者SCr、24h尿总蛋白、尿β2-MG、BUN低于对照组(P<0.05);试验组患者TNF-α、hs-CRP、IL-6低于对照组(P<0.05);试验组患者ET-1、VEGF水平低于对照组,NO水平高于对照组(P<0.05);试验组不良反应发生率为10.87%与对照组8.70%比较差异无统计学意义(P>0.05)。结论:大补元煎加味联合氯沙坦治疗气阴两虚夹瘀证DN具有更好的治疗效果,有助于降低血糖水平,减少蛋白尿,提高肾功能,这可能与减轻炎症水平和改善内皮功能有关。Objective:To explore the curative effect of Modified Dabuyuan Decoction combined with Losartan on diabetic nephropathy(DN)of Qi-Yin deficiency and blood stasis syndrome and its influences on proteinuria and inflammatory factors.Methods:A total of 92 DN patients admitted from March 2019 to June 2020 were enrolled and divided into a experimental group and a controlled group by the random number table method,46 cases in each group.The controlled group was treated with Losartan on the basis of basic treatment,while the experimental group was treated with Modified Dabuyuan Decoction on basis of the controlled group.The curative effect,scores of TCM syndromes,levels of blood glucose indexes[fasting blood glucose(FPG),2 h postprandialblood glucose(PBG),glycosylated hemoglobin(HbA1 C)],renal function indexes[serum creatinine(SCr),24 h urine total protein,urine β2-microglobulin(β2-MG),blood urea nitrogen(BUN)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]and endothelial function indexes[endothelin-1(ET-1),vascular endothelial growth factor(VEGF),nitric oxide(NO)],and adverse reactions were compared between the two groups.Results:After treatment,the total response rate of treatment in the experimental group was higher than that in the controlled group(91.30%vs 73.91%)(P<0.05),scores of TCM syndromes were lower than those in the controlled group(P<0.05),levels of FPG,PBG and HbA1 C were lower than those in the controlled group(P<0.05),SCr,24 h urine total protein,urine β2-MG and BUN were lower than those in the controlled group(P<0.05),levels of TNF-α,hs-CRP and IL-6 were lower than those in the controlled group(P<0.05),levels of ET-1 and VEGF were lower than those in the controlled group,and NO level was higher than that in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the experimental group and the controlled group(10.87%vs 8.70%)(P>0.05).Conclusion:The curative effect of Modified D

关 键 词：大补元煎加味 氯沙坦 气阴两虚夹瘀证 糖尿病肾病 蛋白尿 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]