肾康注射液并序贯肾康栓治疗对糖尿病肾病患者的炎性因子及肾功能的影响  

Clinical Efficacy and Mechanism of Sequential Treatment of Diabetic Nephropathy with Shenkang Injection and Shenkang Suppository

作　　者：李改仙[1] 刘萍[1] 王皓[2] 贺晖英[3] 张虹 车秀英 伍华英 LI Gai-xian;LIU Ping;WANG Hao(General Hospital of North China Petroleum Administration,Renqiu,Hebei,062552)

机构地区：[1]华北石油管理局总医院内分泌科,河北任丘062552 [2]华北石油管理局总医院中医科,河北任丘062552 [3]华北石油管理局井下医院内科,河北任丘062552 [4]华北石油管理局二部医院内科,河北任丘062552

出　　处：《医学临床研究》2019年第12期2313-2316,共4页Journal of Clinical Research

基　　金：河北省中医药管理局科研计划项目(编号:2018517)。

摘　　要：【目的】探讨肾康注射液并序贯肾康栓治疗对糖尿病肾病(DN)患者的炎性因子及肾功能的影响。【方法】选择2017年10月至2018年1月DN患者180例,按照随机数表法分为观察组和对照组。对照组患者给予常规治疗,观察组在对照组治疗基础上给予肾康注射液序贯肾康栓联合治疗,治疗8周。检测并比较两组患者治疗前后血清白介素-17(IL-17)、肿瘤细胞坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)和抵抗素、一氧化氮(NO)、基质金属蛋白酶-9(MMP-9)及肾段动脉收缩期峰值速度(PSV)、舒张末期血流速度(EDV)与阻力指数(RI)。比较两组患者血清同型半胱氨酸(Hcy)、胱抑素-C(Cys-C)、β2微球蛋白(β2-MG)、24小时尿微量白蛋白(24UAE)、血尿酸(UA)、胰岛素抵抗指数(HOMA-IR)。【结果】治疗后,两组患者血清Hcy、Cys-C、β2-MG、24UAE、UA、HOMA-IR较治疗前明显改善,且观察组改善幅度优于对照组,其差异有统计学意义(P<0.05);与治疗前比较,两组患者治疗后血清IL-17、TNF-α、hs-CRP、抵抗素、MMP-9水平降低,NO水平升高(P<0.05),且观察组患者变化更为明显(P<0.05);治疗后,观察组患者PSV速度降低,RI下降,与治疗前比较和对照组治疗后比较均有统计学意义(P<0.05)。观察组不良反应发生率为6.67%,略高于对照组4.44%,其差异无统计学意义(P>0.05)。【结论】肾康注射液并序贯肾康栓治疗可显著减少DN患者尿蛋白含量,改善肾脏组织血流灌注,减轻肾功能损伤,提高患者临床疗效,其可能机制与下调患者体内炎性反应,改善血管内皮细胞功能有关。【Objective】To investigate the clinical efficacy and mechanism of sequential treatment of diabetic nephropathy with Shenkang injection and Shenkang suppository.【Methods】A total of 180 patients with diabetic nephropathy from October 2017 to January 2018 were divided into the observation group and the control group by random number table method,with 90 case in each group.Patients in the control group received routine treatment for diabetic nephropathy,while patients in the observation group received Chinese medicine(Shenkang Injection sequentialy combined with Shenkang suppository treatment)for 8 weeks.Before and after treatment,serum interleukin-17(IL-17)and tumor cell necrosis factor-a(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA);And serum hypersensitive C-reactive protein(hs-CRP)was detected by immunoturbidimetry.The levels of plasma resistin,nitric oxide(NO)and matrix metalloproteinase-9(MMP-9)were measured by Elisa method.The peak systolic velocity(PSV),end diastolic velocity(EDV)and resistance index(RI)of renal artery were measured by Doppler ultrasound.Serum homocysteine(Hcy),cystatin-C(Cys-c),β2-microglobulin(β2-MG),twenty-four hours urinary microalbumin(24UAE),serum uric acid and insulin resistance index(HOMA-IR)were compared between the two groups.【Results】After treatment,the serum Hcy,Cys-C,β2-MG,24UAE,UA,HOMA-IR of the two groups were significantly improved compared to those before treatment.The improvement range of the observation group was better than that of the control group;The difference was statistically significant(P<0.05).Compared to before treatment,the levels of IL-17,TNF-α,hs-CRP,resistin,MMP-9 and NO in the two groups decreased;And the changes in the observation group were more significant(P<0.05).After treatment,the PSV speed and RI in the observation group decreased significantly compared to before treatment and the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.67%,which was slightly higher than that in the contr

关 键 词：糖尿病肾病/药物疗法 药物疗法 联合 

分 类 号：R587.24[医药卫生—内分泌]