益肾降糖饮治疗糖尿病肾脏病Ⅲ期气阴两虚证的临床疗效及对ROS-NLRP3-IL-1β信号通路的影响  

Clinical Efficacy of Yishen Jiangtang Yin(益肾降糖饮)in the Treatment of Diabetic Nephropathy Stage III with Qi-Yin Deficiency Syndrome and Its Effect on ROS-NLRP3-IL-1βSignaling Pathway

作　　者：江铭倩 叶彬华[1] 任莎莉 邱晨[1] JIANG Ming-qian;YE Bin-hua;REN Sha-li;QIU Chen(People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350004,China)

机构地区：[1]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医药导报》2022年第2期61-65,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：福建中医药大学2020年校管课题临床专项(XB2020003);2019年周国英全国名老中医药专家传承工作室建设项目(闽卫中医药〔2019〕21号)。

摘　　要：目的:观察益肾降糖饮治疗糖尿病肾脏病Ⅲ期气阴两虚证的临床疗效及对ROS-NLRP3-IL-1β信号通路的影响。方法:将74例糖尿病肾脏病Ⅲ期气阴两虚证患者随机分为治疗组和对照组,每组37例。对照组患者予西药常规治疗,在饮食、运动、生活方式干预等基础治疗上,控制血糖、血压、血脂。治疗组患者在对照组治疗基础上予益肾降糖饮治疗,治疗时间均为90 d。评价比较两组患者治疗效果,并比较两组患者治疗前后糖代谢指标、肾功能指标、氧化应激指标及炎症指标。结果:治疗组、对照组均剔除2例,对照组、治疗组均35例完成研究;治疗组临床总有效率为82.86%(29/35),对照组临床总有效率为51.43%(18/35),治疗组高于对照组,差异有统计学意义(P<0.05);两组患者治疗后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、尿白蛋白-肌酐比值(UACR)水平均较治疗前降低(P<0.05),且治疗组患者治疗后FPG、HbAlc、UACR水平均低于对照组(P<0.05);治疗组患者治疗后丙二醛(MDA)、NLRP3、白介素-1β(IL-1β)均较治疗前降低(P<0.05),谷胱甘肽(GSH)、超氧化物歧化酶(SOD)水平均较治疗前升高(P<0.05),且治疗组患者治疗后MDA、NLRP3、IL-1β均低于对照组(P<0.05),GSH、SOD均高于对照组(P<0.05)。结论:益肾降糖饮治疗糖尿病肾脏病Ⅲ期气阴两虚证患者有较好临床疗效,能降低血糖及尿白蛋白-肌酐比值,改善氧化应激及炎症反应,其潜在作用机制与介导ROS-NLRP3-IL-1β信号通路发挥抗氧化应激及抗炎作用有关。Objective: To observe the clinical efficacy of Yishen Jiangtang Yin in the treatment of diabetic nephropathy stage Ⅲ with Qi-Yin deficiency syndrome and its effect on ROS-NLRP3-IL-1β signaling pathway.Methods: A total of 74 patients with diabetic nephropathy stage Ⅲ with Qi-Yin deficiency syndrome were randomly divided into treatment group and control group, with 37 cases in each group. Patients in the control group were treated with conventional western medicine, and blood glucose, blood pressure and blood lipid were controlled on the basis of diet, exercise and lifestyle intervention. Patients in the treatment group were treated with Yishen Jiangtang Yin on the basis of the control group, and the treatment time was 90 days. The therapeutic efficacy of the two groups were evaluated and compared, and the glucose metabolism indexes, renal function indexes,oxidative stress indexes and inflammatory indexes of the two groups before and after treatment were compared.Results: 2 cases in the treatment group and the control group were excluded, and 35 cases in the control group and the treatment group completed the study. The total effective rate was 82.86%(29/35) in the treatment group and 51.43%(18/35) in the control group. The treatment group was higher than the control group, and the difference was statistically significant(P <0.05). After treatment, the levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c) and urinary albumin-creatinine ratio(UACR) in the two groups were lower than those before treatment(P<0.05), and the levels of FPG, Hb Alc and UACR in the treatment group were lower than those in the control group(P<0.05). After treatment, the levels of malondialdehyde(MDA), NLRP3 and IL-1β in the treatment group were lower than those before treatment(P<0.05), and the levels of glutathione(GSH)and superoxide dismutase(SOD) were higher than those before treatment(P<0.05). After treatment, the levels of MDA, NLRP3 and IL-1β in the treatment group were lower than those in the control group(P<0.

关 键 词：糖尿病肾脏病Ⅲ期 气阴两虚证 益肾降糖饮 氧化应激 NLRP3炎症小体 ROS-NLRP3-IL-1β信号通路 

分 类 号：R256.51[医药卫生—中医内科学]