燮理糖肾颗粒治疗早期糖尿病肾病临床疗效及对肾纤维化的影响  

Clinical Efficacy of Xielitangshen Granules in the Treatment of Early Diabetic Nephropathy and Its Effect on Renal Fibrosis

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作  者:苏文弟[1] 梁汝圣[1] 秦莉[1] 张柏林[1] SU Wendi;LIANG Rusheng;QIN Li;ZHANG Bailin(The First Hospital of Tianjin)

机构地区:[1]天津市第一医院糖尿病科,300232

出  处:《长治医学院学报》2022年第3期183-188,共6页Journal of Changzhi Medical College

摘  要:目的:观察燮理糖肾颗粒对早期糖尿病肾病患者的临床疗效及对肾纤维化的影响。方法:将120例早期糖尿病肾病(DN)患者随机分为2组,观察组71例,对照组49例,对照组给予西药基础治疗,观察组在西医基础治疗的基础上加用燮理糖肾颗粒,2组治疗疗程均为6个月。记录治疗前后2组患者一般情况、中医证候积分,比较肾功能相关指标、肾纤维化相关指标、血糖相关指标、炎症相关指标的变化。结果:治疗后观察组有效率(86.56%)与对照组(67.39%)比较差异有统计学意义(P<0.05);2组患者治疗后尿蛋白肌酐比(UP/CR)、24 h尿微量白蛋白排泄率(UAE)、转化生长因子β1(TGF-β1)、尿β2-微球蛋白(β2-MG)、N-乙酰-β-D-葡萄糖苷酶(NAG)均较治疗前明显下降(P<0.05),且观察组UP/CR、TGF-β1、β2-MG低于对照组,差异有统计学意义(P<0.05);2组患者治疗后血清前胶原肽Ⅲ(PCⅢ)[(121.36±10.57)vs(147.36±11.65)ng·mL^(-1)]、四型胶原(Ⅳ-C)[(88.29±9.77)vs(121.45±10.77)ng·mL^(-1)]、透明质酸(HA)[(131.86±21.31)vs(197.58±20.56)mg·L^(-1)]、层粘联蛋白(LN)[(105.34±11.72)vs(121.65±10.38)ng·mL^(-1)]水平均较治疗前明显降低,且观察组优于对照组(P<0.05);2组患者治疗后炎性相关指标白介素6、肿瘤坏死因子α(TGF-α)、超敏C反应蛋白(Hs-CRP)明显下降,且观察组明显低于对照组(P<0.05);2组患者治疗后肾小球滤过率明显升高,且观察组明显高于对照组[(78.24±14.83)vs(69.38±14.15)mL·min^(-1)·1.73 m^(-2),P<0.05]。结论:燮理糖肾颗粒结合西医治疗早期糖尿病肾病较单纯西药治疗在改善患者临床症状、保护肾功能、改善肾纤维化方面更具有优势。Objective:To observe the effect of Xielitangshen granules on patients with early diabetic nephropathy and its effect on renal fibrosis.Methods:120 patients with early diabetic nephropathy(DN)were randomly divided into two groups,71 cases in the observation group and 49 cases in the control group.The control group was given basic western medicine treatment,the observation group was given XieLitangshen granules based on basic western medicine treatment,and the treatment course of both groups was 6 months.The general conditions and the TCM syndrome scores before and after treatment in the two groups of patients were recorded,and the changes in renal function-related indexes,renal fibrosis-related indexes,blood sugar-related indexes,and inflammation-related indexes were compared.Results:After treatment,the effective rate of the observation group(86.55%)was significantly higher than that of the control group(67.39%)(P<0.05).After treatment,the UP/CR,UAE,TGF-β1,β2-MG,and NAG of the two groups were significantly decreased(P<0.05),and the UP/CR,TGF-β1 andβ2-MG in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,PCⅢ[(121.36±10.57)vs(147.36±11.65)ng·mL^(-1)],Ⅳ-C[(88.29±9.77)vs(121.45±10.77)ng·mL^(-1)],HA[(131.86±21.31)vs(197.58±20.56)mg·L^(-1)],LN[(105.34±11.72)vs(121.65±10.38)ng·mL^(-1)]levels were significantly lower than those before treatment,and the observation group was better than the control group(P<0.05).After treatment,the inflammatory-related indexes IL-6,TNF-α,Hs-CRF decreased significantly,and the observation group was significantly lower than the control group(P<0.05).After treatment,the glomerular filtration rate in the two groups was significantly increased,and the observation group was significantly higher than the control group[(78.24±14.83)vs(69.38±14.15)mL·min^(-1)·1.73 m^(-2),P<0.05].There was no significant difference in FBG and 2 hBG between the two groups after treatment.Conclusion:Xie l

关 键 词:燮理糖肾颗粒 糖尿病肾病 肾纤维化 胰岛素抵抗 慢性肾脏疾病 

分 类 号:R587.2[医药卫生—内分泌]

 

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