糖尿病肾病湿热证与尿ADPN、L-FABP关系临床研究  

Clinical study on the relationship between dampness-heat syndrome in diabetic nephropathy and urine ADPN and urine L-FABP

作　　者：姚洁琼 崔赵丽[2] 高艳霞[1] YAO Jieqiong;CUI Zhaoli;GAO Yanxia(Shanxi Traditional Chinese Medical Hospital/Shanxi Provincial Institute of Traditional Chinese Medicine,Taiyuan 030012,China;Tongzhou District,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China)

机构地区：[1]山西省中医院/山西省中医药研究院,太原030012 [2]北京中医药大学东直门医院通州院区,北京101121

出　　处：《吉林中医药》2023年第12期1429-1433,共5页Jilin Journal of Chinese Medicine

基　　金：北京市通州区科技计划项目(KJ2022CX065);山西省中医药研究院院级课题(201802)。

摘　　要：目的如何通过中西医结合提高糖尿病肾病的临床疗效具有重要意义。从湿热证与尿ADPN、L-FABP的关系入手,通过对90例糖尿病肾病患者进行临床研究,为糖尿病肾病诊疗提供思路与方法。方法糖尿病肾病患者90例,根据肾络癥瘕理论,分为早期组、中期组、晚期组,采用SPSS 21.0版统计软件,研究湿热证与糖尿病肾病分期、临床症状、临床指标、尿ADPN、L-FABP的关系,为运用和解聚散方(黄芪、当归、海藻、生牡蛎、鳖甲)加减延缓肾脏纤维化进程开拓思路。结果随着糖尿病肾病病程由早期进展到晚期,湿热证早期11例、中期12例、晚期9例,可见湿热证贯穿其病程始终。大便干结或黏腻不爽(32例)、小便黄赤(27例)、口黏口臭(15例)是湿热证中最常见的症状。随着糖尿病肾病病程由早期进展到晚期,口黏口臭(2例增多到10例)、小便黄赤(4例增多到12例)等症状越来越明显。湿热组与非湿热组血红蛋白、尿素氮、血肌酐比较,均无统计学意义(P>0.05);湿热证组与非湿热证组的24 h尿蛋白定量比较,2组比较差异具有统计学意义(P<0.05)。湿热证组的尿ADPN、L-FABP较非湿热证组高,差异具有统计学意义(P<0.05)。结论湿热在糖尿病肾病的发生发展过程中,有着重要的作用,清利湿热法在糖尿病肾病的治疗过程中具有重要意义。本研究有助于提高中医学辨证的客观化水平,有助于提高临床辨证水平,有助于提高糖尿病肾病临床疗效。Objective To investigate the relationship between the dampness-heat syndrome in diabetic nephropathy with urine ADPN and urine L-FABP.Methods A total of 90 patients with diabetic nephropathy were divided into an early group,a middle group and a late group according to the theory of kidney collateral mass.The relationship between the dampness-heat syndrome and the stage of diabetes nephropathy,clinical symptoms,clinical indicators,urine ADPN,urine L-FABP was studied by using the SPSS 21.0 statistical software,so as to open up a new way of thinking for the use of modified Hejie Jusan Recipe to delay the process of renal fibrosis.Results As the course of diabetic nephropathy progressed from an early stage to a late stage,there were 11 cases of dampness-heat syndrome in the early stage,12 cases in the middle stage,and 9 cases in the late stage.Dry or sticky stools(32 cases),yellow and red urine(27 cases),and sticky and bad breath(15 cases)were the most common symptoms in the dampnessheat syndrome.With the progression of diabetic nephropathy from an early stage to a late stage,the symptoms of sticky mouth and bad breath(2 cases increased to 10 cases),yellow and red urine(4 cases increased to 12 cases)and other symptoms became more and more obvious.There was no statistically significant difference in hemoglobin,urea nitrogen,and creatinine between the dampness-heat syndrome group and the non dampness-heat syndrome group,(P>0.05).The quantitative comparison of 24-hour urine protein between the dampness-heat syndrome group and the non dampness-heat syndrome group showed a statistically significant difference(P<0.05).The levels of urine ADPN and L-FABP in the dampness-heat syndrome group were significantly higher than those in the non dampness-heat syndrome group(P<0.05).Conclusion Dampness-heat plays an important role in the occurrence and development of diabetic nephropathy,and the method of clearing away dampness-heat is of great significance in its treatment.This study helps to improve the objectification level of TCM

关 键 词：糖尿病肾病 湿热证 肾络癥瘕理论 尿ADPN 尿L-FABP 

分 类 号：R228[医药卫生—中医基础理论]