自拟黄芪玉米须汤在单核苷酸多态性2型糖尿病肾病治疗中的应用研究  

Study on application of Astragalus corn soup in treatment of type 2 diabetic nephropathy with singlenucleotide polymorphism

作　　者：杨国宗[1] 苏小惠[2] 杨丽阳[2] 吴小芳[1] 戴秀娟[2] 潘诚志 

机构地区：[1]漳州市中医院检验科,福建漳州363000 [2]漳州市中医院糖尿病科,肾病科,福建漳州363000

出　　处：《临床和实验医学杂志》2015年第21期1781-1784,共4页Journal of Clinical and Experimental Medicine

基　　金：漳州市自然科学基金项目(编号:ZZ2012J39);福建省卫生厅中医药科研课题(编号:wztn201310)

摘　　要：目的探讨脂联素(APN)基因启动子区-11377C/G单核苷酸多态性(SNP)与自拟黄芪玉米须汤治疗2型糖尿病肾病(DN)疗效的关系。方法选取68例DN患者为研究对象,口服自拟黄芪玉米须汤3个月,并定期检测患者生化指标,同时采用聚合酶链反应扩增技术(PCR)筛选DN患者脂联素基因(a PM1)启动子多态性位点,分析脂联素基因(a PM1)-11377C/G基因型对黄芪玉米须汤治疗DN效果的影响。结果 68例DN患者中,CC、CG、GG基因型频率分别为35.29%(24/68)、29.41%(20/68)、35.29%(24/68),G、C等位基因频率分别为56.02%、43.98%。CC、CG基因型总有效率显著高于GG型,差异有统计学意义(P<0.05)。CC、CG基因型治疗后FBG、TC、TG、LDL-C、BUN、HOMA-IR较GG基因型显著下降,而HDL-C、APN高于GG基因型,差异有统计学意义(P<0.05)。经Logistic多因素分析,HOMA-IR、GG基因型是影响黄芪玉米须汤治疗DN临床疗效的独立危险因素,而ANP则是保护因素。结论自拟黄芪玉米须汤能有效改善DN患者肾功能,提高患者治疗效果,但a PM1-11377C/G基因多态性可影响芪玉米须汤治疗DN的效果,临床可根据DN易感人群特质选择合适的治疗方案,以更好地提高DN治疗效果。Objective To explore the relationship between adiponectin（APN）gene promoter region - 11377C / G single nucleotide polymorphism（SNP）and Astragalus corn soup in treatment of patients with type 2 diabetic nephropathy（DN）. Methods A total of sixty - eight patients with DN were treated with the proposed oral Astragalus corn soup for three months. The（aPM1）promoter polymorphism in patients with DN was screened by polymerase chain reaction amplification（PCR）and the r - 11377C / impact analysis of adiponectin gene（aPM1）G genotype ofAstragalus and effect of corn treatment for DN were analyzed. Results The frequencies of CC,CG and GG genotypes in 68 patients with DN was 35. 29%（24 / 68）,29. 41%（20 / 68）and 35. 29%（24 / 68）respectively,andfrequencies of G and C alleles were 56. 02% and 43. 98% re-spectively. CC and CG genotypes were significantly higherthan the total efficiency of GG genotype,and the difference was statistically significant（ P ﹤ 0. 05）. The levels of FBG,TC,TG,LDL - C,BUN and HOMA - IR in CC and CG genotypes after treatment were significantly decreased-compared with those of GG genotype,whereas the levels of HDL - C and APN were higher than those of GG genotype,and the difference was sta-tistically significant（ P ﹤ 0. 05 ）. The HOMA - IR in GG genotype was an independent risk factor to the effect of Astragalus corn soup on clinical efficacy of DN,while ANP was a protective factor with logistic regression analysis. Conclusion Astragalus corn soup can effectively improve the renal function ofpatients with DN and improve the outcome of patients,but the polymorphism of aPM1 - 11377C / G may affect the treatment of DN with corn soup,and clinicians can select the appropriate program of treatment according to DN susceptibility in order to improve the therapeutic effect for DN.

关 键 词：2 型糖尿病肾病 黄芪玉米须汤 脂联素 单核苷酸多态性 

分 类 号：R587.2[医药卫生—内分泌]