防己黄芪汤治疗糖尿病肾病患者炎性因子及Toll样受体相关机制研究  

Study on Related Mechanism of Inflammatory Factors and Toll-Like Receptors in Patients with Diabetic Nephropathy Treated by Fangji Huangqi Decoction(防己黄芪汤)

作　　者：幸婷婷 张敏[1] 陈丽平[1] 陈光华[1] 李文东[1] XING Tingting;ZHANG Min;CHEN Liping;CHEN Guanghua;LI Wendong(Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院,四川南充637000

出　　处：《辽宁中医杂志》2023年第5期133-137,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：四川省教育科研课题(SWFZ18-C-9);南充市科技项目(19SXHZ0163)。

摘　　要：目的研究防己黄芪汤治疗糖尿病肾病患者炎性因子及Toll样受体相关机制。方法该研究为前瞻性研究,选取该院2018年5月-2021年6月进行诊断并治疗的糖尿病肾病患者120例作为研究对象,两组患者均采取控制血压、调整调整饮食、使用胰岛素以及抗血小板聚集性药物,同时口服氯沙坦钾片进行治疗,观察组患者在此基础上联合采取防己黄芪汤进行治疗,两组患者均治疗12周。比较两组患者的治疗效果、血糖、血脂、应激、炎性指标、Toll样受体之间的差异。结果经过治疗后,两组患者的主症评分、次症评分以及总分均显著降低,且观察组患者的主症评分(t=5.373,P=0.000)、次症评分(t=4.099,P=0.000)以及总分(t=4.940,P=0.000)显著低于对照组;经过治疗后,两组患者的FBG、HbA1c、MBG、BGFR、SDBG显著下降,且观察组患者的FBG(t=4.119,P=0.000)、HbA1c(t=8.830,P=0.000)、MBG(t=13.499,P=0.000)、BGFR(t=35.010,P=0.000)、SDBG(t=35.010,P=0.000)显著低于对照组,两组患者甘油三酯、总胆固醇水平、低密度脂蛋白明显下降,高密度脂蛋白明显上升,且观察组患者的甘油三酯(t=2.751,P=0.007)、总胆固醇水平(t=7.275,P=0.000)、低密度脂蛋白(t=2.449,P=0.000)低于对照组,高密度脂蛋白(t=4.421,P=0.000)高于对照组,经过治疗后,两组患者的Renin、E、ACEIⅡ、NE显著升高,但观察组患者的Renin、E、ACEIⅡ、NE显著低于对照组;两组患者的IL-1β、TNF-α以及IL-6均显著下降,且观察组患者的IL-1β(t=16.532,P=0.000)、TNF-α(t=3.656,P=0.000)以及IL-6(t=2.451,P=0.016)显著低于对照组;两组患者的TLR4、TLR7均显著下降,且观察组患者的TLR4(t=16.139,P=0.000)、TLR7(t=3.543,P=0.001)显著低于对照组;两组患者发生肝功能、肾功能、尿常规、心电图、血白细胞计数异常情况之间差异无统计学意义(P>0.05)。结论防己黄芪汤治疗糖尿病肾病患者炎性因子及Toll样受体显著降低,治疗效果较好,建议Objective To study the mechanism of Fangji Huangqi Decoction(防己黄芪汤)in the treatment of inflammatory factors and Toll-like receptors(TLR)in patients with diabetic nephropathy.Methods This study was a prospective study.A total of 120 patients with diabetic nephropathy who were diagnosed and treated in the hospital in May 2018—June 2021 were selected.The two groups were treated with blood pressure control,adjusting diet,using insulin and anti-platelet aggregation drugs,and taking Losartan Potassium Tablets at the same time.On this basis,the patients in the observation group were treated with Fangji Huangqi Decoction.Both groups were treated for 12 weeks.The differences of treatment effect,blood glucose,blood lipid,stress,inflammatory index and Toll-like receptor between the two groups were compared.Results After treatment,the main symptom score,secondary symptom score and total score of the two groups decreased significantly,and the main symptom score(t=5.373,P=0.000),secondary symptom score(t=4.099,P=0.000)and total score(t=4.940,P=0.000)of the observation group were significantly lower than those of the control group.After treatment,the levels of fasting blood glucose(FBG),hemoglobin A1c(HbA1c),mean blood glucose(MBG),24-hour blood glucose fluctuation level(BGFR)and standard deviation of 24-hour blood glucose(SDBG)in the two groups decreased significantly,and the levels of FBG(t=4.119,P=0.000),HbA1c(t=8.830,P=0.000),MBG(t=13.499,P=0.000),BGFR(t=35.010,P=0.000)and SDBG(t=35.010,P=0.000)in the observation group were significantly lower than those in the control group.The levels of triglyceride(t=2.751,P=0.007),total cholesterol(t=7.275,P=0.000)and lowdensity lipoprotein(t=2.449,P=0.000)in the observation group were lower than those in the control group,and the levels of high-density lipoprotein(t=4.421,P=0.000)were higher than those in the control group.After treatment,the levels of renin,ACEIⅡand norepinephrine(NE)increased significantly,but the levels in the observation group were significantly lower

关 键 词：糖尿病肾病 防己黄芪汤 炎性因子 TOLL样受体 氧化应激 

分 类 号：R587.2[医药卫生—内分泌]