当归补血汤加味联合西医治疗糖尿病肾病的疗效及对足细胞损伤的影响  

Effect of Danggui Buxue Decoction combined with western medicine on diabetic nephropathy and its effect on podocyte injury

作　　者：王正 刘蕊[1] 王培[1] WANG Zheng;LIU Rui;WANG Pei(Traditional Chinese Medicine Center,Beijing Luhe Hospital,Capital Medical University,Beijing 100110,China)

机构地区：[1]首都医科大学附属北京潞河医院中医中心,北京100110

出　　处：《川北医学院学报》2023年第5期676-680,共5页Journal of North Sichuan Medical College

基　　金：首都医科大学附属北京潞河医院科研项目(2021-KY-103)。

摘　　要：目的:探讨当归补血汤加味联合西医治疗糖尿病肾病(DKD)的疗效及其对足细胞损伤、氧化应激的影响。方法:选取101例DKD患者为研究对象,按照治疗方案的不同分为对照组(n=51)与中药组(n=50)。对照组予以常规西医治疗,中药组予以当归补血汤加味联合西医治疗,两组均连续治疗3个月。比较两组疗效及安全性,于治疗前及治疗3个月,检测并比较肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、预估肾小球滤过率(eGFR)、24 h尿蛋白定量(24 h UAE)、尿白蛋白/肌酐比值(UACR)]、尿足细胞损伤相关指标[膜蛋白(Podocin)、α平滑肌肌动蛋白(α-SMA)]和血清氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]的水平。结果:中药组总有效率为92.00%,高于对照组的76.47%(P<0.05)。治疗后,中药组Scr、BUN、24 h UAE、UACR水平均低于对照组(P<0.05),eGFR水平高于对照组(P<0.05);尿Podocin、α-SMA水平均低于对照组(P<0.05);血清SOD水平高于对照组(P<0.05),MDA水平低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:当归补血汤加味联合西医治疗DKD疗效较好,能够有效减轻氧化应激,保护足细胞损伤,减少蛋白尿,改善肾功能。Objective:To investigate the effect of Danggui Buxue Decoction combined with western medicine on diabetic kidney disease(DKD)and its effect on podocyte injury and oxidative stress.Methods:A total of 101 patients with DKD were divided into control group(n=51)and Chinese medicine group(n=50)according to different treatment methods.The control group was treated with conventional western medicine,and the Chinese medicine group was treated with Danggui Buxue Decoction combined with western medicine.Both groups were treated continuously for 3 months.The efficacy and safety of the two groups were compared.The renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),24 h urinary protein quantification(24 h UAE),urinary albumin/creatinine ratio(UACR)],urinary podocyte injury related indexes[membrane protein(Podocin),α-smooth muscle actin(α-SMA)]and serum oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]were measured and compared before treatment and 3 months after treatment.Results:The total effective rate of the Chinese medicine group was 92.00%,which was higher than 76.47%of the control group,and the difference was significant(P<0.05).After treatment,the levels of Scr,BUN,24 h UAE and UACR in the Chinese medicine group were lower than those in the control group(P<0.05),and the eGFR level was higher than that in the control group(P<0.05).The levels of urinary Podocin andα-SMA in the Chinese medicine group were lower than those in the control group(P<0.05),the serum SOD level in the Chinese medicine group was higher than that in the control group(P<0.05),and the MDA level was lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Danggui Buxue Decoction combined with western medicine is effective in the treatment of DKD,which can effectively reduce oxidative stress,protect podocyte injury,reduce proteinuria and improve renal fun

关 键 词：糖尿病肾病 当归补血汤 足细胞损伤 肾功能 氧化应激 

分 类 号：R285.5[医药卫生—中药学]