肾炎康复片联合阿魏酸哌嗪片对糖尿病肾病微循环障碍的影响  

Effect of Shenyan Kangfu Tablets Combined with Piperazine Ferulate Tablets on Microcirculation Disturbance of Patients with Diabetic Nephropathy

作　　者：祝继英[1] 王明贤[2] 秦佰焰 封加福 江玉[4] 

机构地区：[1]雅安职业技术学院,四川雅安625500 [2]乐山职业技术学院,四川乐山614000 [3]峨眉山市中医院,四川乐山614200 [4]泸州医学院附属中医院,四川泸州646000

出　　处：《中国实验方剂学杂志》2014年第15期212-216,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：四川省教育厅项目(川教函[2011]538号11ZB130)

摘　　要：目的:探讨肾炎康复片联合阿魏酸哌嗪片治疗糖尿病肾病的疗效及对微循环障碍的影响。方法:65例患者采用随机按数字法分为观察组和对照组。对照组31例采用常规西医治疗,厄贝沙坦片,150 mg/次,1次/d,口服;观察组34例在对照组治疗的基础上加用肾炎康复片,5片/次,3次/d,口服;阿魏酸哌嗪片,4片/次,3次/d,口服。两组疗程均为12周。检测治疗前后24 h尿微量白蛋白排泄率(UAER)、24 h尿蛋白定量和血清肌酐(Scr);检测治疗前后血液流变学;检测治疗前后血清一氧化氮(NO)、内皮素1(ET-1)、血栓素(TXB2)、6-酮-前列腺素F_1a)(6-Keto-PGF_1a)、超氧化物歧化酶(SOD)和硫代巴比妥酸比色法检测丙二醛(MDA)水平。结果:观察组疾病疗效总有效率为88.24%,优于对照组的67.74%(P<0.05);治疗后两组UAER、24 h尿蛋白定量和Scr水平均较治疗前下降(P<0.01),观察组UAER、24 h尿蛋白定量和Scr水平低于对照组(P<0.01);治疗后观察组全血黏度(低切、高切)、全血还原黏度、血小板聚集指数、血浆黏度和纤维蛋白原的改善优于对照组(P<0.01);观察组治疗后NO和和6-Keto-PGF_1a水平高于对照组(P<0.01);治疗后观察组ET-1和TXB2水平低于对照组(P<0.01);治疗后两组SOD水平升高,观察组SOD水平高于对照组(P<0.01);两组MDA水平较治疗前下降,观察组MDA水平低于对照组(P<0.01)。结论:在血管紧张素受体拮抗剂(ARB)等药物常规治疗的基础上,肾炎康复片和阿魏酸哌嗪片联合治疗DN能减轻蛋白尿,保护肾功能,其作用机制可能与改善血液流变学、调节血管内皮功能、减轻氧化应激,抑制血小板的黏附聚集,增加肾血流灌注,从而改善肾微循环障碍有关。Objective：To discuss curative efficacy of Shenyan Kangfu tablets combined with piperazine ferulate tablets and influence to microcirculation disturbance in treating diabetic nephropathy （DN）.Method：Sixty-five patients were randomly divided into control group （31 cases） and observation group （34 cases） by digital method.Patients in the control group received irbesartan tablets of conventional western medicine treatment with 150 mg/time and 1 time/d.Based on treatment of the control group,patients in the observation group added Shenyan Kangfu tablets with 5 tablets/time and 3 times/d by taken orally,and piperazine ferulate tablets took orally with 4 tablets/time and 3 times/d.Course of treatment in those two groups were both 12 weeks.Before and after treatment,24 hours urinary albumin excretion rate （UAER）,24 hours urine protein quantitation and serum creatinine （Scr） were detected,hemorheology was also detected,levels of serous nitric oxide （NO）,endothelin-1 （ET-1）,thromboxane （TXB2）,6-Ketone-prostaglandin F_ （la） （6-Keto-PGF_ la） and superoxide dismutase （SOD） were detected,level of malondialdehyde （MDA） was measured with thiobarbituric acid chromatometry.Result：Total effective rate of curative efficacy in the observation group was 88.24％ superior to 67.74％ in the control group （P ＜ 0.05）.After treatment,compared with time before treatment,levels of UAER,24 hours urine protein quantitatio and Scr in those two groups decreased （P ＜ 0.01）,which in the observation group were lower than those in the control group （P ＜ 0.01）.Amelioration of whole blood viscosity （low shear and high shear）,blood reduced viscosity,platelet aggregation index,plasma viscosity and fibrinogen in the observation group were superior to those in the control group （P ＜0.01）,levels of NO and 6-Keto-PGF_1a in the observation group were higher than those in the control group （P ＜0.01）,levels of ET-1 and TXB2 in the observation group were lower than those in

关 键 词：糖尿病肾病 肾炎康复片 阿魏酸哌嗪片 血液流变性 微循环障碍 

分 类 号：R287[医药卫生—中药学]