温肾解毒汤联合复方α-酮酸片治疗肾虚血瘀型糖尿病肾病的临床效果及对血清肝细胞生长因子、凝血酶激活的纤溶抑制物、白介素-21水平的影响  

Clinical effects of Wenshen Jiedu decoction combined with compound α-ketoacid tablets in treating renal deficiency and blood stasis type diabetic nephropathy and its influence on levels of serum hepatocyte growth factor,thrombin-activated fibrinolytic inhibitor and interleukin-21

作　　者：陈宪典 刘巧梅 杜昊炎 刘胜杰 CHEN Xiandian;LIU Qiaomei;DU Haoyan;LIU Shengjie(Department of Nephrology,Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476002,Henan Province,China)

机构地区：[1]商丘市中医院肾病科,河南商丘476002

出　　处：《世界临床药物》2023年第6期587-593,共7页World Clinical Drug

基　　金：河南省医学科技攻关计划项目(2019020854)。

摘　　要：目的 分析温肾解毒汤联合复方α-酮酸片治疗肾虚血瘀型糖尿病肾病(diabetic nephropathy,DN)的效果及对血清肝细胞生长因子(hepatocyte growth factor,HGF)、凝血酶激活的纤溶抑制物(thrombin-activatable fibrinolysis inhibitor,TAFI)、白介素(interleukin,IL)-21水平的影响。方法 选取2020年1月至2022年1月商丘市中医院肾病科门诊收治的肾虚血瘀型DN患者160例,按照随机数字表法分为对照组及试验组,每组80例。两组均在控制血糖前提下口服卡托普利,对照组加用复方α-酮酸片,试验组在对照组基础上加服温肾解毒汤。持续治疗3个月后评定疗效、不良反应发生情况,并分析两组治疗前后中医证候积分、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、24 h尿蛋白排泄率(24-hour urinary protein excretion rate,24hUAER)、血肌酐(serum creatinine,Scr)、肾小球滤过率(esti mated glomerular filtration rate,eGFR)、血清HGF、TAFI及IL-21水平变化。结果 试验组总有效率高于对照组(91.25%vs 80.00%,P <0.05)。试验组较对照组治疗1个月、治疗3个月中医证候积分低(P <0.05)。两组FBG、2hPG、HbA1c、24hUAER、Scr、GFR及血清HGF、TAFI、IL-21水平均明显改善,且试验组改善更显著(P <0.05)。结论 温肾解毒汤联合复方α-酮酸片能有效调控肾虚血瘀型DN患者血清HGF、TAFI、IL-21水平,控制血糖,改善肾功能,疗效及安全性佳。Objective To analyze the effects of Wenshen Jiedu decoction combined with compoundα-ketoacid tablets on renal deficiency and blood stasis type diabetic nephropathy(DN),and its effects on serum hepatocyte growth factor(HGF),thrombin-activatable fibrinolysis inhibitor(TAFI)and interleukin(IL)-21 levels.Methods A total of 160 DN patients with renal deficiency and blood stasis admitted to the department of nephrology,Shangqiu hospital of traditional Chinese medicine(TCM)from January 2020 to January 2022 were selected and divided into control group and experimental group according to random number table method,with 80 cases in each group.Both groups were given captopril orally under the precondition of controlling blood glucose, the control group was given compound α-ketoacid tablets, and the experimentalgroup was given Wenshen Jiedu decoction on the basis of the control group. After 3 months continuous treatment, the efficacyand the occurrence of adverse reactions were evaluated, and the TCM syndrome scores, fasting blood glucose(FBG), 2-hourpostprandial blood glucose(2hPG), glycosylated hemoglobin(HbA1c), 24-hour urinary protein excretion rate(24hUAER),serum creatinine(Scr), esti mated glomerular filtration rate(eGFR), serum HGF, TAFI and IL-21 before and after treatmentwere analyzed in both groups. Results The total effective rate of experimental group was higher than that of controlgroup(91.25% vs 80.00%, P<0.05). The scores of TCM syndromes in experimental group were lower than those in controlgroup after 1 month and 3 months of treatment(P<0.05). The levels of FBG, 2hPG, HbA1c, 24hUAER, Scr, eGFR andserum HGF, TAFI and IL-21 in both groups were significantly improved, and the improvements in experimental group weremore significant(P<0.05). Conclusion Wenshen Jiedu decoction combined with compound α-ketoacid tablet can effectivelyregulate serum HGF, TAFI and IL-21 levels, control blood glucose and improve renal function in DN patients with renaldeficiency and blood stasis, with good efficacy and safety.

关 键 词：温肾解毒汤 复方Α-酮酸片 肾虚血瘀型 糖尿病肾病 中医证候积分 

分 类 号：R277.5[医药卫生—中医学] R259R587.2