肾康丸联合舒洛地特软胶囊治疗气阴两虚型糖尿病肾病疗效及对患者尿微小RNA-192表达的影响  

Effect of Shenkang pills combined with sulodexide soft capsules in the treatment of diabetic nephropathy with qi-yin deficiency type and its influence on the expression of urinary microRNA-192

作　　者：温智勇 夏金金 江伟强[2] WEN Zhiyong;XIA Jinjin;JIANG Weiqiang(Department of Pharmacy,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510280)

机构地区：[1]南方医科大学珠江医院药剂科,广东广州510280 [2]南方医科大学珠江医院中医科,广东广州510280

出　　处：《河北中医》2020年第7期1028-1033,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81873346,81774035)。

摘　　要：目的观察肾康丸联合舒洛地特软胶囊治疗气阴两虚型糖尿病肾病(DN)疗效及对患者尿微小RNA-192(miR-192)表达的影响。方法将120例气阴两虚型DN患者按照随机数字表法分为3组。治疗组40例予肾康丸联合舒洛地特软胶囊治疗,对照1组40例予肾康丸治疗,对照2组40例予舒洛地特软胶囊治疗。3组疗程为6个月。比较3组治疗前后尿miR-192及血清转化生长因子β1(TGF-β1)、Smad蛋白1(Smad1)、Smad蛋白2(Smad2);炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6);肾功能指标尿素氮(BUN)、血肌酐(Cr)、尿白蛋白排泄率(UAER)、胱抑素C(Cys-C)、估算肾小球滤过率(eGFR)、24 h尿蛋白定量(24 h UP);血糖指标空腹血糖(FPG)、糖化血红蛋白(HbA 1c)。结果治疗组总有效率100%(40/40),对照1组总有效率85.0%(34/40),对照2组总有效率82.5%(33/40),治疗组疗效优于对照1组和对照2组(P<0.05)。治疗后3组尿miR-192、血清TGF-β1、血清Smad1、血清Smad2表达均较本组治疗前降低(P<0.05),且治疗后治疗组尿miR-192,血清TGF-β1、Smad2均低于对照1组、对照2组(P<0.05)。治疗后3组FPG、HbA 1c均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照1组、对照2组(P<0.05)。治疗后3组TNF-α、IL-6均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照1组、对照2组(P<0.05)。治疗后3组24 h UP、BUN、Cr、Cys-C均较本组治疗前降低(P<0.05),eGFR均升高(P<0.05),且治疗后治疗组24 h UP、BUN、Cr、Cys-C均低于对照组1组、对照2组(P<0.05),eGFR高于对照1组、对照2组(P<0.05)。3组UAER治疗前后比较差异无统计学意义(P>0.05)。治疗组患者治疗前后尿miR-192表达下降与Cr、Cys-C、BUN、Smad1、TGF-β1呈正相关(P<0.05)。结论肾康丸联合舒洛地特软胶囊治疗DN能有效降低患者尿miR-192的表达,降低血肌酐,减少尿蛋白排泄,延缓肾衰竭进展,疗效确切,安全性高,值得推广应用。Objective To observe the effect of Shenkang pills combined with sulodexide soft capsules in the treatment of diabetic nephropathy(DN)with qi-yin deficiency type and its influence on the expression of urinary microRNA-192(miR-192).Methods 120 patients with DN of qi-yin deficiency type were randomly divided into three groups according to the random number table method.40 cases in the treatment group were treated by Shenkang Pills combined with sulodexide soft capsules.40 cases in the control group 1 were treated by Shenkang Pills.40 cases in the control group 2 were treated by sulodexide soft capsules.The urinary microRNA-192(miR-192),transforming growth factor-β1(TGF-β1),Smad Protein 1(Smad1),Smad Protein 2(Smad2),inflammatory factors tumor necrosis factor-α(TNF-α),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),gastric function indexes such as urea nitrogen(BUN),serum creatinine(CR),urinary albumin excretion rate(UAER),Cystatin C(Cys-C),estimated glomerular filtration rate(eGFR),24-hour urinary protein(24 h UP),fasting blood glucose(FPG)and glycosylated hemoglobin(HbA 1c)were compared among the three groups before and after treatment.Results The total effective rate of the treatment group was 100%(40/40),that of the control group 1 was 85.0%(34/40),and that of the control group 2 was 82.5%(33/40).The curative effect of the treatment group was better than that of the control group 1 and 2(P<0.05).After treatment,the expressions of urine miR-192,serum TGF-β1,serum Smad1 and serum Smad2 in the three groups were all lower than those in the group before treatment(P<0.05),and the urine miR-192,serum TGF-β1,serum Smad2 of treatment group were lower than the control group 1 and control group 2(P<0.05).After treatment,FPG and HbA 1c in the three groups were lower than those in the group before treatment(P<0.05),and the treatment group was lower than the control group 1 and control group 2(P<0.05).After treatment,the levels of TNF-αand IL-6 in the three groups were lower than those in the group before treatment

关 键 词：糖尿病肾病 中西医结合疗法 

分 类 号：R587.240.58[医药卫生—内分泌]