黄葵胶囊对早期糖尿病肾脏疾病患者胰岛素抵抗和尿微量白蛋白的多靶点治疗作用  

Multi-targeted therapeutic effects of Huangkui Capsules on insulin resistance and urine microalbumin in early diabetic kidney disease patients

作　　者：吴薇[1] 刘莹露[1] 万毅刚[1] 曹东维[2] 房其军[3] 涂玥 刘不悔 王文文 王美子 YEE Hong-yun 袁灿灿 胡巍[6] WU Wei;LIU Ying-lu;WAN Yi-gang;CAO Dong-wei;FANG Qi-jun;TU Yue;LIU Bu-hui;WANG Wen-wen;WANG Mei-zi;YEE Hong-yun;YUAN Can-can;HU Wei(Department of Traditional Chinese Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Nephrology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Traditional Chinese Medicine,Nanjing Drum Tower Hospital Clinical College of Chinese Medicine and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210008,China;Department of Traditional Chinese Medicine Health Preservation,Acupuncture and Moxibustion and Massage College·Health Preservation and Rehabilitation College,Nanjing University of Chinese Medicine,Nanjing 210023,China;Nephrology Division,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;Department of Pharmacy,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院中医科,江苏南京210008 [2]南京大学医学院附属鼓楼医院肾内科,江苏南京210008 [3]南京中医药大学中西医结合鼓楼临床医学院中医科,江苏南京210029 [4]南京中医药大学针灸推拿学院·养生康复学院中医养生学教研室,江苏南京210023 [5]南京中医药大学附属医院肾内科,江苏南京210029 [6]南京大学医学院附属鼓楼医院药学部,江苏南京210008

出　　处：《中国中药杂志》2020年第23期5797-5803,共7页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金面上项目(81573903);国家自然科学基金青年基金项目(81603675);江苏省中医药科技发展计划项目(YB201937);南京市医学科技发展基金资助项目(QRX17042);南京市名中医专家工作室建设项目。

摘　　要：观察黄葵胶囊(Huangkui Capsules,HKC)对早期糖尿病肾脏疾病(diabetic kidney disease,DKD)患者胰岛素抵抗(insulin resistance,IR)和尿微量白蛋白的多靶点治疗作用。收集83例G2,A2期DKD患者的病例资料,进行回顾性分析。根据不同干预措施将全部患者分为对照(A)组40例和治疗(B)组43例。其中,A组患者接受的治疗措施是"常规基础治疗";B组患者接受的治疗措施是"常规基础治疗+HKC"。对于2组患者,先比较其在接受干预措施前的基线参数,再比较其在接受干预措施8周后的中医证候总积分以及IR、尿蛋白、肾功能、血脂、安全性指标的变化情况,并且,针对全部DKD患者干预前后IR指标与尿蛋白指标、中医证候总积分分别进行相关性分析。结果表明,对于接受"常规基础治疗+HKC"干预措施的B组患者,其中医证候总积分、尿蛋白指标[包括尿微量白蛋白(urine microalbumin,micro-UAlb)、尿微量白蛋白/尿肌酐(urine microalbumin/urinary creatinine,UACR)]、IR主要指标[包括空腹血清胰岛素(fasting serum insulin,FIN)、稳态模型评估IR指数(homeostasis model assessment of IR,HOMA-IR)]均有明显改善;全部DKD患者干预前后IR主要指标(FIN,HOMA-IR)与尿蛋白指标(micro-UAlb,UACR)均呈正相关;全部DKD患者干预前后IR主要指标(FIN,HOMA-IR)与中医证候总积分亦呈正相关。此外,2种干预措施对全部DKD患者肾功能、血脂以及安全性指标均无明显影响。总之,"常规基础治疗联合HKC"的干预措施不仅能改善早期DKD患者IR,还能减少尿微量白蛋白。其治疗靶点不只在蛋白尿,还可能是蛋白尿的上游致病因素——IR。To observe the multi-targeted therapeutic effects of Huangkui Capsules(HKC)on insulin resistance(IR)and urine microalbumin in the early diabetic kidney disease(DKD)patients.The case data from the 83 DKD patients at G2 and A2 stage were collected respectively and analyzed retrospectively.According to the different treatment,all patients were divided into the control(A)group(40 cases)and the treated(B)group(43 cases).Among them,the A group patients were received"routine basic treatment";the B group patients were received"routine basic treatment+HKC".For the 2 group patients,firstly,the baseline parameters before receiving the treatment were compared respectively,and then,the changes of the total scores of traditional Chinese medicine(TCM)syndromes and the indicators of IR,urine protein,renal function,blood lipids and safety after receiving the treatment for 8 weeks were compared,respectively.Furthermore,for the all patients,the correlation analysis between IR and urine protein or IR and the total scores of TCM syndromes was carried out,respectively.The results showed that,for the B group patients received"routine basic treatment",their total scores of TCM syndromes,urine protein indicators including urine microalbumin(micro-UAlb)and urine microalbumin/urinary creatinine(UACR),IR indicators including fasting serum insulin(FIN)and homeostasis model assessment of insulin resistance(HOMA-IR)were significantly improved,respectively.For the all DKD patients,before and after the treatment,the main IR indicators(FIN and HOMA-IR)were positively correlated with urine protein indicators(micro-UAlb and UACR).The main IR indicators(FIN and HOMA-IR)were also positively correlated with the total scores of TCM syndromes.In addition,2 treatments had no significant effects on renal function,blood lipids and safety indicators in the all DKD patients.Overall,"routine basic treatment+HKC"can ameliorate IR and reduce urine microalbumin in the early DKD patients.Its therapeutic targets may be not only proteinuria,but also IR,which is the

关 键 词：糖尿病肾脏疾病 黄葵胶囊 胰岛素抵抗 尿微量白蛋白 

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