滋阴通络肾元汤对早中期糖尿病肾病AngⅡ、RBP、CYS-C、HCY水平的影响研究  

Influence of Ziyin Tongluo Shenyuan Decoction(滋阴通络肾元汤)on AngⅡ,RBP,CYS-C and HCY of Patients with Diabetic Nephropathy

作　　者：尹翰林 万沁 王晓茜[2] 王艳[2] YIN Hanlin;WAN Qin;WANG Xiaoxi;WANG Yan(The Affiliated Hospital of Southwest Medical University,Luzhou 646099,Sichuan,China;People’s Hospital of Deyang,Deyang 618099,Sichuan,China)

机构地区：[1]西南医科大学附属医院,四川泸州646099 [2]德阳市人民医院,四川德阳618099

出　　处：《中华中医药学刊》2021年第10期112-115,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点研发计划精准医学重点专项“代谢性疾病专病队列研究”子课题(2016YFC0901205)。

摘　　要：目的探讨滋阴通络肾元汤对早中期糖尿病肾病患者AngⅡ、RBP、CYS-C、HCY水平的影响。方法选择2018年3月—2020年4月医院收治的早中期糖尿病肾病患者84例,依据随机对照法将患者分为观察组和对照组,每组42例。对照组采用生活方式调节和西药常规治疗,即接受糖尿病教育,适度运动,低盐、低蛋白饮食,在治疗期间禁酒。口服格列喹酮以控制血糖;口服厄贝沙坦降压;血脂高者口服辛伐他汀分散片以降低血脂。观察组在对照组治疗的基础上,口服滋阴通络肾元汤治疗。两组均治疗3个月。比较两组治疗前后中医证候积分,比较治疗疗效,比较两组治疗前后UAER、24h-UTP、BUN、SCr、AngⅡ、RBP、CYS-C和HCY水平变化。结果观察组治疗总有效率为90.48%(38/42),对照组治疗总有效率为73.81%(31/42),观察组治疗疗效高于对照组(P<0.05)。观察组治疗后神疲乏力、咽干口渴、腰膝酸软、夜尿频多、手足心热和大便干等中医证候积分低于对照组(P<0.05);观察组治疗后肾功能指标UAER、24h-UTP、BUN和SCr水平低于对照组(P<0.05);观察组治疗后AngⅡ、RBP、CYS-C和HCY水平低于对照组(P<0.05)。结论滋阴通络肾元汤辅助治疗早中期糖尿病肾病效果确切,可有效的改善患者的中医证候,减少微量白蛋白尿并改善肾功能,其机制可能与抑制患者微炎症反应、保护肾小球功能有关。Objective To investigate the influence of Ziyin Tongluo Shenyuan Decoction(滋阴通络肾元汤)on levels of AngⅡ,RBP,CYS-C and HCY of patients with diabetic nephropathy.s Methods Eighty-four patients with early-stage diabetic ne-phropathy admitted to our hospital from March 2018 to April 2020 were selected and divided into observation group and control group according to the randomized control method,with 42 patients in each group.The control group received lifestyle regulation and conventional treatment with western medicine,namely diabetes education,moderate exercise,low-salt,low-protein diet,and prohibition of alcohol during treatment.Oral administration of glaziquantel was for blood glucose control.Oral administration of Irbesartan was for blood pressure reduction.Patients with high lipid profile took simvastatin dispersible tablets to reduce lipid profile.The observation group was treated by Ziyin Tongluo Shenyuan Decoction orally on the basis of the control group.Both groups were treated for 3 months.We compared two groups’TCM symptom integral before and after treatment,the treatment effect and the levels of UAER,24 h-UTP,BUN,SCr,AngⅡ,RBP,CYS-C and HCY before and after treatment.s Results The total effective rate was 90.48%(38/42)in the observation group and 73.81%(31/42)in the control group.The therapeutic effect of the observation group was higher than that of the control group(P<0.05).After treatment,the scores of TCM syndromes in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of TCM symptoms such as mental fatigue,dry throat and thirst,weak waist and knees,frequent nocturia,heat hands and feet,and dry stool were lower in the two groups than those before treatment,while the scores in the observation group were lower than those in the control group(P<0.05).The levels of UAER,24 h-UTP,BUN and SCr in the observation group were lower than those in the control group after treatment(P<0.05).The observation group’s levels of AngⅡ,RBP,CYS-C and HCY

关 键 词：滋阴通络肾元汤 糖尿病肾病 早中期 气阴两虚、血瘀络阻型 机制 

分 类 号：R259.872[医药卫生—中西医结合]