加减参芪地黄汤对糖尿病肾病患者氧化应激指标及血清转化生长因子β1、基质金属蛋白酶-9、金属蛋白酶组织抑制剂1水平的影响  

Effects of Modified ShenqiDihuang Decoction on Oxidative Stress Indexes and Serum Levels of TGF-β1,MMP-9,and TIMP-1 in Patients with Diabetic Nephropathy

作　　者：马娟娟 任磊 刘红梅[4] MA Juan-juan;REN Lei;LIU Hong-mei(The Second People's Hospital of Shangluo(Affliated Hospital of Shangluo Vocational and Technical College),Shangluo Henan 726000;Shangluo Vocational and Technical College,Shangluo Henan 726000;Community Health Service Center of Chang'an Road,Beilin District,Shangluo Henan 710068;Beijing University of Chinese Medicine,Beijing 100029)

机构地区：[1]商洛市第二人民医院(商洛职业技术学院附属医院),河南商洛726000 [2]商洛职业技术学院,河南商洛726000 [3]碑林区长安路社区卫生服务中心,河南商洛710068 [4]北京中医药大学,北京100029

出　　处：《世界中西医结合杂志》2022年第4期826-830,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省医学科技攻关项目(2020200185)。

摘　　要：目的探讨加减参芪地黄汤对糖尿病肾病患者氧化应激指标及血清转化生长因子β1(Transforming growth factor beta 1,TGF-β1)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、金属蛋白酶组织抑制剂1(Tissueinhibitor of metalloproteinase-1,TIMP-1)水平的影响。方法选取2019年12月—2020年12月期间商洛市第二人民医院收治的96例Ⅳ型糖尿病肾病患者为研究对象,按随机数字表法将其分为研究组和对照组,每组各48例。对照组给予基础治疗加胰岛素,研究组在对照组治疗基础上给予加减参芪地黄汤治疗。治疗6个月后,观察比较两组患者治疗前后对肾功能[血肌酐(Serum creatinine,SCr)、尿β2微球蛋白(Urinaryβ2-microgloblin,β2-MG)、尿蛋白定量(Urine protein,UTP)],氧化应激指标[丙二醛(Malondialdehyde,MDA)、超氧化物歧化物(Superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(Glutathione Peroxidose,GSH-Px)],血清TGF-β1、MMP-9、TIMP-1水平,并观察治疗后临床疗效。结果两组患者治疗后头晕耳鸣,多食易饥,倦怠乏力,盗汗自汗,五心烦热、口渴喜饮,心烦失眠、SCr、β2-MG、UTP、MDA、TGF-β1、TIMP-1水平均降低,SOD、GSH-Px、MMP-9水平较治疗前升高,差异有统计学意义(P<0.05);研究组头晕耳鸣,多食易饥,倦怠乏力,盗汗自汗,五心烦热、口渴喜饮,心烦失眠、SCr、β2-MG、UTP、MDA、TGF-β1、TIMP-1水平均较对照组明显降低,SOD、GSH-Px、MMP-9水平较对照组升高,总有效率高于对照组,差异有统计学意义(P<0.05)。结论加减参芪地黄汤能够有效改善糖尿病肾病患者临床症状,调节氧化应激指标及TGF-β1、MMP-9、TIMP-1水平,防止肾脏纤维化,值得临床推广使用。Objective To explore the effects of modified ShenqiDihuang Decoction on oxidative stress indexes and serum levels of transforming growth factor beta 1(TGF-β1),matrix metalloproteinase-9(MMP-9),and tissueinhibitor of metalloproteinase-1(TIMP-1)in patients with diabetic nephropathy.Methods A total of 96 patients with typeⅳdiabetic nephropathy admitted to the Second People′s Hospital of Shangluo from December 2019 to December 2020 were enrolled and divided into a treatment group(n=48)and a control group(n=48)according to a random number table.All patients received basic treatment combined with insulin,while those in the treatment group were additionally treated with modifiedShenqiDihuangDecoction.After 6 months of treatment,renal function indexes[serum creatinine(SCr),urinaryβ2-microglobulin(β2-MG),and urine protein(UTP)],oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)],serum TGF-Px,MMP-9,and TIMP-1 of the two groups were observed and compared.The clinical efficacy was observed after treatment.Results After treatment,the scores of traditional Chinese medicine(TCM)symptoms(dizziness,tinnitus,overeating and rapid hungering,fatigue,night sweating,spontaneous sweating,vexing heat in chest,palms and soles,thirst and desire to drink,irritability,and insomnia),SCr,β2-MG,UTP,MDA,TGF-β1,and TIMP-1 of the two groups decreased and the levels of SOD,GSH-Px,and MMP-9 increased as compared with those before treatment(P<0.05).The scores of TCM symptoms(dizziness,tinnitus,overeating and rapid hungering,fatigue,night sweating,spontaneous sweating,vexing heat in chest,palms and soles,thirst and desire to drink,irritability,and insomnia),SCr,β2-MG,UTP,MDA,TGF-β1,and TIMP-1 of the treatment group were lower and the levels of SOD,GSH-Px,and MMP-9 were higher than those in the control group.The treatment group was superior to the control group in the total effective rate(P<0.05).Conclusion Modified ShenqiDihuang Decoction can effectively improve the clinical symptoms o

关 键 词：加减参芪地黄汤 Ⅳ型糖尿病肾病 肾功能 氧化应激指标 血清转化生长因子Β1 基质金属蛋白酶-9 金属蛋白酶组织抑制剂1 

分 类 号：R587.2[医药卫生—内分泌]