参芪补胰方配伍消渴方治疗老年糖尿病肾病患者的效果及对血清TGF-β1、MMP9、TIMP1水平的影响  

Effect of combination of Shenqi Buyi Prescription with Xiaoke Prescription for the treatment of elderly patients with diabetic nephropathy and the influence on serum TGF-β1,MMP9 and TIMP1 levels

作　　者：李娜 熊久红 杨倩 张鹏 LI Na;XIONG Jiuhong;YANG Qian;ZHANG Peng(Center for Hemodialysis of Traditional Chinese Medicine Department,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China;Department of Nephrology,Wuhan Wuchang Hospital,Wuhan 430063,Hubei,China)

机构地区：[1]恩施州土家族苗族自治州中心医院中医部血液透析中心,湖北省恩施市445000 [2]武汉市武昌医院肾内科,湖北省武汉市430063

出　　处：《广西医学》2023年第13期1562-1567,共6页Guangxi Medical Journal

基　　金：湖北省卫生健康委员会联合基金项目(WJ2019H259)。

摘　　要：目的探讨参芪补胰方配伍消渴方治疗阴阳两虚、瘀血水停型老年糖尿病肾病(DN)患者的临床效果,以及对血清转化生长因子β1(TGF-β1)、基质金属蛋白酶9(MMP9)、组织型金属蛋白酶抑制剂1(TIMP1)水平的影响。方法将102例阴阳两虚、瘀血水停型老年DN患者随机分为对照组和观察组,每组51例。给予两组常规西医治疗,同时给予观察组参芪补胰方配伍消渴方治疗。比较两组治疗前后的中医症状积分、血糖和HbA1c水平、肾功能指标[24 h尿蛋白含量、尿β_(2)微球蛋白(β_(2)MG)含量]、胰岛β细胞功能指标[空腹胰岛素(FINS)水平、稳态模型的胰岛素抵抗(HOMA-IR)指数、稳态模型的胰岛素敏感(HOMA-IS)指数]及血清生化指标(血清TGF-β1、MMP9、TIMP1水平)。比较两组的临床疗效。结果治疗12周后,两组中医症状总积分较治疗前减少,空腹血糖水平、餐后2 h血糖水平、HbA1c水平、24 h尿蛋白含量、尿β_(2)MG含量、血清TGF-β1水平、血清TIMP1水平、HOMA-IR指数、FINS水平均较治疗前降低,血清MMP9水平及HOMA-IS指数均较治疗前升高,且观察组上述指标均优于对照组(均P<0.05)。观察组的总有效率高于对照组,临床疗效优于对照组(均P<0.05)。结论与单纯常规西医治疗比较,参芪补胰方配伍消渴方联合常规西医治疗阴阳两虚、瘀血水停型老年DN患者的效果确切,不仅可以更好地改善胰岛β细胞功能,降低血糖水平,而且可以更有效地调控TGF-β1、MMP9和TIMP1的表达从而发挥更优的肾功能保护作用。Objective To explore the clinical effect of combination of Shenqi Buyi Prescription with Xiaoke Prescription for the treatment of elderly patients with diabetic nephropathy(DN)in type of yin-yang deficiency and stagnation of blood and dampness,and the influence on levels of serum transforming growth factorβ1(TGF-β1),matrix metalloproteinase 9(MMP9),and tissue inhibitor of metalloproteinase 1(TIMP1).Methods A total of 102 elderly patients with DN in type of yin-yang deficiency and stagnation of blood and dampness were randomly divided into control group or observation group,with 51 cases in each group.Routine Western Medicine therapy was given to both groups,simultaneously,the observation group was treated with combination of Shenqi Buyi Prescription with Xiaoke Prescription.The pre-and post-treatment Traditional Chinese Medicine symptom scores,and levels of blood glucose and HbA1c,renal function indices with respect to 24 h urine protein content,urineβ_(2)-microglobulin(β_(2)MG)content,pancreatic isletβcell function indices(fasting insulin[FINS]level,homeostasis model assessment of insulin resistance[HOMA-IR]index,and HOMA of insulin sensitivity[HOMA-IS]index),as well as serum biochemical indicators(serum TGF-β1,MMP9,and TIMP1 levels)were compared between patients of the two groups.The clinical efficacy was compared between the two groups.Results After 12 weeks of treatment,the total score of Traditional Chinese Medicine symptoms of the two groups was decreased as compared with before treatment,fasting blood glucose level,2-hour postprandial blood glucose level,HbA1c level,24 h urine protein content,urineβ_(2)MG content,serum TGF-β1 and TIMP1 levels,HOMA-IR index,FINS level were decreased as compared with before treatment,whereas serum MMP9 level and HOMA-IS index were elevated as compared with before treatment;moreover,the observation group exhibited superior aforementioned indices to compared with the control group(all P<0.05).The total effective rate of the observation group was higher than that of the

关 键 词：糖尿病肾病 阴阳两虚 瘀血水停 参芪补胰方 消渴方 老年人 临床效果 转化生长因子β1 基质金属蛋白酶9 组织型金属蛋白酶抑制剂1 

分 类 号：R587.2[医药卫生—内分泌]