补脾益肾活血法对糖尿病肾病患者氧化应激水平及炎症因子的影响  

Effect of Spleen- and- kidney- tonifying and Blood- circulating Therapy on the Oxidative Stress and Inflammatory Factors of Patients with Diabetic Nephropathy

作　　者：王晓光[1] 谭婷婷[1] 任迪[2] 

机构地区：[1]广州中医药大学祈福医院肾病科,广州511495 [2]广州中医药大学祈福医院ICU,广州511495

出　　处：《中国中西医结合肾病杂志》2015年第12期1063-1067,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：广州市番禺区卫生系统各学科临床医学或疾病防治领域的一般引导项目(No.2013-Z03-26)

摘　　要：目的：观察中药补脾益肾活血法对糖尿病肾病（DN）患者的氧化应激水平及炎症因子的影响,从而防治蛋白氧化的损伤。方法：选择2013年9月~2014年9月在广州中医药大学祈福医院肾病科的住院和门诊的DN患者60例,按照国际统一诊断标准（Mogensen诊断分期标准）及血清肌酐分为早期糖尿病肾病组（DN1组）22例：尿微量白蛋白排泄率（UAER）持续20~200μg/min;临床糖尿病肾病组（DN2组）18例：UAER〉200μg/min;终末期糖尿病肾病组（DN3组）20例：UAER〉200μg/min且Cr〉445μmol/L。DN1、DN2、DN3组使用中药补脾益肾活血方治疗,所有入组成员给予常规基础治疗,检测各组治疗前后晚期氧化蛋白产物（AOPP）、晚期糖基化终末产物（AGE）、超氧化物歧化酶（SOD）、超敏C反应蛋白（hs CRP）及白细胞介素-6（IL-6）的水平。结果：随着DN的发展,DN患者体内AOPP、AGE、hs CRP及IL-6水平增加（P〈0.05）,SOD活性下降（P〈0.05）,AOPP与SOD显著负相关。治疗后,从中医临床症状总疗效来看,3组均显示了补脾益肾活血法有显著治疗效果,DN1组显效率为54.55%,总有效率为95.45%;DN2组显效率为38.89%,总有效率为88.89%;DN3组显效率为40.00%,总有效率为85.00%。3组均能改善患者的尿微量白蛋白。DN1、DN2、DN3组血清AOPP、AGE、hs CRP及IL-6、UAER水平在治疗4周后与治疗前比较均有明显下降（P〈0.01）,SOD水平较治疗前明显升高（P〈0.01）。结论：中药补脾益肾活血法对DN患者的保护作用机制,可能与其抗氧化应激及抑制炎症反应相关。Objective： To observe the effect of spleen- and- kidney- tonifying and blood- circulating therapy on reducing or even removing the oxidative stress and inflammatory factors of patients with diabetic nephropathy for the purpose of preventing protein oxidation damage. Methods： A total of 60 diabetic patients were selected with diabetic nephropathy who received inpatient and outpatient services from the Nephropathy Department of Clifford Hospital between September 2013 and September 2014,and they were divided into the following groups according to the globally- accepted diagnostic criteria（ Mogensen＇s staging criteria） and their serum creatinine level： early diabetic nephropathy group（ DN1 group） 22 cases： UAER sustained 20 ~ 200 μg / min; clinical diabetic nephropathy group（ DN2 group） 18 cases： UAER 200 μg / min; end- stage diabetic nephropathy group（ DN3 group） 20 cases：UAER 200 μg / min and Cr 445 μmol / L. All patients in the DN1,DN2,and DN3 groups received Chinese herbal treatments to invigorate the spleen and kidney and to promote blood circulation. Routine treatments were applied to the patients and the levels of their AOPP,AGE,SOD,hs CRP and IL- 6 were examined before and after the treatment. Results： With the development of DN,the levels of serum AOPP,AGE,hs CRP and IL- 6 increased（ P 0. 05）,and the activity of SOD decreased（ P 0. 05）. AOPP and SOD were significantly negative correlated. After the treatment,in terms of the total effect of traditional Chinese medicine for clinical symptoms,a significant therapeutic effect was shown in these three groups with regard to spleen and kidney tonification and blood circulation promotion. The effective rate for DN1 was 54. 55%,and the total effective rate was 95. 45%; the effective rate for DN2 was38. 89%,and the total effective rate was 88. 89%; the effective rate for DN3 was 40. 00%,and the total effective rate was 85. 00%.The patients＇ UAERs in these three groups were all reduced. For all the three groups,the levels

关 键 词：补脾益肾活血法 糖尿病肾病 晚期氧化蛋白产物 炎症因子 

分 类 号：R285.6[医药卫生—中药学]