自拟黄芪参七汤治疗糖尿病肾病的效果及对患者血清miRNA-21和NF-κB表达的影响  

Effects of self-made Huangqi Shenqi decoction on diabetic nephropathy and the expression of serum microRNA-21 and NF-κB

作　　者：王琳 Wang Lin(Department of Endocrinology, Sanmenxia Hospital of Traditional Chinese Medicine, Sanmenxia 472000, China)

机构地区：[1]河南省三门峡市中医院中医内分泌科,472000

出　　处：《中国实用医刊》2019年第15期109-113,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨自拟黄芪参七汤治疗糖尿病肾病的效果及其对患者血清miRNA-21和核因子-κB(NF-κB)表达的影响。方法选取三门峡市中医院2016年2月至2018年7月收治的糖尿病肾病患者100例,按照就诊顺序分为对照组和观察组,每组50例。两组均给予糖尿病常规治疗,对照组给予胰岛素或二甲双胍控制血糖,并采用依那普利片控制血压;观察组在对照组治疗基础上加用黄芪参七汤。两组患者均连续治疗8周。观察记录两组患者治疗前后中医症候评分、24h尿蛋白量、尿蛋白排泄率(UAER)、尿微量白蛋白定量(ALB)、尿白蛋白与肌酐比值(ACR)、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、血清NF-κB、血清miRNA-21水平和不良反应发生情况,评价治疗效果。结果治疗后,观察组24h尿蛋白定量、UAER、ALB、ACR、FPG、2hPG、HbA1c和血清NF-κB水平均较治疗前降低,并低于对照组,差异有统计学意义(P<0.05);观察组总有效率为90.00%,高于对照组的72.00%(P<0.05);观察组血清miRNA-21水平升高,并高于对照组(P<0.05);观察组中医症候评分低于对照组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论黄芪参七汤治疗糖尿病肾病效果显著,能够有效控制患者血糖,并改善肾功能,其机制与促进miRNA-21表达、抑制NF-κB表达有关,安全性好,值得推广。Objective To investigate the effects of self-made Huangqi Shenqi decoction on diabetic nephropathy and the expression of serum microRNA-21 and nuclear factor-κB (NF-κB). Methods One hundred patients with diabetic nephropathy admitted to Sanmenxia Hospital of Traditional Chinese Medicine from February 2016 to July 2018 were selected and randomly divided into control group and observation group according to the order of treatment, with 50 cases in each group. Both groups were given routine treatment of diabetes, while the control group was given insulin or metformin to control blood sugar, and given enalapril tablets to control blood pressure;the observation group was given Huangqi Shenqi decoction on the basis of the control group. Both groups were treated for 8 weeks. Traditional Chinese medicine (TCM) symptoms score, 24 h urinary protein, urinary protein excretion rate (UAER), urinary microalbumin quantification (ALB), urinary albumin to creatinine ratio (ACR), fasting plasma glucose (FPG), postprandial 2 h plasma glucose (2 h PG), glycosylated hemoglobin (HbA1c), serum NF-κB and serum miRNA-21 levels and adverse reactions were observed and recorded before and after treatment in both groups. The therapeutic effect of the two groups were evaluated. Results After treatment, the 24 h urinary protein, UAER, ALB, ACR and the levels of FPG, 2 h PG, HbA1c, serum NF-κB in observation group were significantly lower than those before treatment, and lower than those in control group (P<0.05). The total effective rate of the observation group was 90.00%, higher than 72.00% of the control group (P<0.05). After treatment, the serum level of microRNA21 in observation group was higher than that before treatment, and higher than that in control group (P<0.05);and the scores of TCM symptoms in observation group was lower than that in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions Huangqi Shenqi decoction has remarkable effects on d

关 键 词：糖尿病肾病 黄芪参七汤 MIRNA-21 核因子-ΚB 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]