丹蛭降糖胶囊对早期糖尿病肾病患者血NF-κB和尿微量蛋白排泄率及中远期疗效的影响  

Effect of Danzhi Jiangtang Capsule (DJC) on NF-ΚB,Urinary Albumin Excretion Rate and Mid-Long Term Efficacy in Early Diabetic Nephropathy (EDN) Patients

作　　者：程森华 陈安 方朝晖[2] 吴倩[2] 

机构地区：[1]绍兴市上虞中医医院,浙江绍兴312300 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中华中医药学刊》2014年第10期2338-2341,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81072780);国家中医药管理局国家中医药临床研究基地建设项目(20081211);国家科技部重大项目(2010ZX09102)

摘　　要：目的:观察丹蛭降糖胶囊对早期糖尿病肾病(EDN)患者外周血单个核细胞中核因子-κB(NF-κB)和血清MCP-1、TGF-β1等炎症指标、尿微量蛋白排泄率(UAER)及中远期临床疗效的影响,探讨丹蛭降糖胶囊对EDN抗炎作用及肾保护的可能机理。方法:导入期后符合纳入标准的72例EDN患者作为研究对象,随机分为对照组和治疗组。两组均采用以缬沙坦为基础的西医综合治疗方案,治疗组在此基础上加用丹蛭降糖胶囊,两组疗程均为2月,第6个月末结束时随访。观察两组治疗前后及第6个月随访时患者MCP-1、NF-κB、TGF-β1及UAER的变化,并评价疾病综合疗效,比较两组患者中远期疗效差异。结果:两组治疗后MCP-1、NF-κB、TGF-β1及UAER的水平与同组治疗前比较,差异有统计学意义(P<0.05),治疗组的作用更加明显(P<0.01);两组随访时MCP-1、NF-κB、TGF-β1及UAER水平的组间比较,差异有统计学意义(P<0.05或P<0.01)。两组治疗后中医证侯总积分与同组治疗前比较,差异有统计学意义(P<0.05),治疗组中医证侯总积分下降更明显(P<0.01);两组治疗后及随访时中医证侯总积分组间比较,差异有统计学意义(P<0.05)。治疗组治疗后的总有效率76.5%,随访时的总有效率70.6%,分别与对照组治疗后的总有效率57.1%,随访时的总有效率54.3%比较,差异有统计学意义(P<0.01);两组随访时与治疗后自身比较,差异无统计学意义(P>0.05)。结论:丹蛭降糖胶囊可降低尿微量蛋白排泄率,延缓肾脏损伤,综合临床疗效优于现有综合治疗方案,且中远期疗效稳定。而其下调患者血MCP-1、NF-κB及TGF-β1的水平,阻断炎症介质的表达,抑制炎症反应,改善EDN微炎症状态,可能是保护肾脏功能的机制之一。Objective ：To observe the effect of DJC on indices of inflammation such as NF- κB,serum MCP- 1,TGF- β1,urinary albumin excretion rate（UAER） in EDN patients＇ peripheral blood mononuclear cell and its mid- long term effect,and to discuss the possible mechanism of DJC on anti- inflammatory effect and renal protection of EDN. Method：72 EDN patients which met the inclusion criteria after the start- up stage were as the object of the research and divided into the control group and the treatment group randomly. The two groups both used the western comprehensive treatment plan with valsartan,and the treatment group added DJC on the basis of it. The courses of the treatment were both 2 months and the follow- up time started at the end of 6th month. We observed the changes of MCP- 1,NF- κB,TGF- β1 and UAER before and after the treatment as well as the follow- up,evaluated the comprehensive effects of disease and compared the difference of the mid- long term effect between two groups. Result After the treatment,the levels of MCP- 1,NF- κB,TGF- β1 and UAER of two groups had statistical significance（ P〈0. 05）,and the treatment group had moreobvious effect（ P〈0. 01）. The difference of the levels of MCP- 1,NF- κB,TGF- β1 and UAER during the follow-up time between two groups had statistical significance（ P〈0. 05 or P〈0. 01）. TCM syndrome total score of each group had statistical significance compared with itself after the treatment（ P〈0. 05）,and the treatment group＇s score decreased more obviously（ P〈0. 01）. The difference of TCM syndrome total score between the two groups after the treatment and during the follow- up time had statistical significance（ P〈0. 05）. The total effective rates of the treatment group after the treatment and during the follow- up were 76. 5% and 70. 6% respectively,and the control group＇s total effective rates after the treatment and during the follow- up were 57. 1% and 54. 3% respectively and the difference of the rate between two groups had

关 键 词：丹蛭降糖胶囊 早期糖尿病肾病 尿微量蛋白排泄率 核因子-ΚB 中远期疗效 

分 类 号：R781.63[医药卫生—口腔医学]