益气养阴活血汤对糖尿病肾病AGEs-RAGE轴及血清TNF-α、IL-6水平的影响  

Effect of YiqiYangyinHuoxue Decoction on AGEs RAGE axis and serum TNF in diabetes nephropathy-α、Observation of the effect of IL-6 level

作　　者：艾志敏[1] 张成才[1] 陈方明[1] AI Zhi-min;ZHANG Cheng-cai;CHEN Fang-ming(Department of Nephrology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou Sichuan 635000)

机构地区：[1]达州市中西医结合医院肾病科,四川达州635000

出　　处：《世界中西医结合杂志》2022年第12期2454-2459,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：四川省中医药管理局科研项目(2019B035)。

摘　　要：目的探究益气养阴活血汤经晚期糖基化终末产物(Advanced glycation end products,AGEs)-晚期糖基化终末产物受体(Receptor of Advanced Glycation Endproducts,RAGE)轴调节机制对早期糖尿病肾病(Diabetic nephropathy,DN)的治疗价值。方法选取2019年12月—2021年8月期间达州市中西医结合医院肾病科收治的88例早期DN患者,采用随机数字表法分为对照组和治疗组,每组各44例。对照组给予常规西医治疗,治疗组在对照组基础上联合益气养阴活血汤治疗。治疗8周后,观察比较两组患者综合疗效、不良反应发生率,治疗前后中医证候积分(主症、次症、总积分)、尿液指标[尿白蛋白排泄率(Urinary albumin excretion rates,UAER)、尿微量白蛋白(Microalbunminuria,mAlb)]、AGEs-RAGE轴因子(AGEs、RAGE)、炎症因子[肿瘤坏死因子-α(Tumour necrosis factor-α,TNF-α)、白介素-6(Interleukin-6,IL-6)]水平及生活质量(A-DQOL)评分。结果治疗后治疗组总有效率93.18%(41/44)明显高于对照组79.07%(34/43),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分(主症、次症、总积分),尿液指标(UAER、mAlb),AGEs-RAGE轴因子水平(血清AGEs、RAGE)、炎症因子水平(TNF-α、IL-6),生活质量(A-DQOL各维度)评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医证候积分(主症、次症、总积分),尿液指标(UAER、mAlb),AGEs-RAGE轴因子水平(血清AGEs、RAGE)、炎症因子水平(TNF-α、IL-6),生活质量(A-DQOL各维度)评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗期间,治疗组不良反应发生率15.91%与对照组13.95%比较,差异无统计学意义(P>0.05)。结论益气养阴活血汤治疗早期DN安全、有效,有利于减轻蛋白尿,下调炎症反应,改善患者生活质量,可能与经AGEs-RAGE轴的调节机制有关。Objective To explore the therapeutic value of Yiqi Yangyin Huoxue Decoction in the treatment of early diabetic nephropathy(DN)through the regulatory mechanism of advanced glycation end products(AGEs)-receptor of advanced glycation end products(RAGE)axis.Methods Eighty-eight patients with DN in the Department of Nephrology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine were randomly divided into a control group and a treatment group,with 44 cases in each group.The control group was given conventional western medicine treatment,and the treatment group was combined with Yiqi Yangyin Huoxue Decoction on this basis.Both groups were treated for 8 weeks.The comprehensive curative effect,incidence of adverse reactions,traditional Chinese medicine(TCM)symptom scores(main symptom score,secondary symptom score,and total score),urine indicators[urinary albumin excretion rate(UAER)and microalbumin urine(mAlb)],AGEs-RAGE axis factors(AGEs and RAGE),the levels of inflammatory factors[tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)],and adjusted diabetes quality of life(A-DQOL)scores before and after treatment in the two groups were compared.Results After treatment,the total effective rate of the comprehensive curative effect in the treatment group was 93.18%(41/44),which was higher than that in the control group[79.07%(34/43)](P<0.05).Compared with those before treatment,the TCM symptom scores(main symptom score,secondary symptom score,and total score),urine indicators(UAER and mAlb),AGEs-RAGE axis factors(AGEs and RAGE),the levels of inflammatory factors(TNF-αand IL-6),and A-DQOL scores in the two groups were lower after treatment(P<0.05).In addition,the TCM symptom scores(main symptom score,secondary symptom score,and total score),urine indicators(UAER and mAlb),AGEs-RAGE axis factors(AGEs and RAGE),the levels of inflammatory factors(TNF-αand IL-6),and A-DQOL scores in the treatment group were all significantly lower than those in the control group(P<0.05).During treatment,the incidence of ad

关 键 词：早期糖尿病肾病 AGEs-RAGE信号通路 益气养阴活血汤 TNF-Α IL-6 

分 类 号：R587.2[医药卫生—内分泌]