消渴肾安汤联合氯沙坦对糖尿病肾病患者肾血管内皮功能及尿液足细胞跨膜蛋白水平的影响  

Effects of Xiaoke Shen′an decoction combined with losartan on renal vascular endothelial function and urine podocyte transmembrane protein level in patients with diabetic nephropathy

作　　者：梅建锋 杨艳[1] 尹骁翔 MEI Jianfeng;YANG Yan;YIN Xiaoxiang(Department of Nephrology,Wujin Hospital of TCM,Changzhou 213161,Jiangsu Province,China)

机构地区：[1]常州市武进中医医院肾病科,江苏常州213161

出　　处：《新乡医学院学报》2024年第11期1022-1027,共6页Journal of Xinxiang Medical University

摘　　要：目的探讨消渴肾安汤联合氯沙坦对糖尿病肾病(DN)患者肾血管内皮功能及尿液足细胞跨膜蛋白水平的影响。方法选择2022年3月至2023年12月常州市武进中医医院门诊收治的102例DN患者为研究对象,按照治疗方法将患者分为观察组和对照组,每组51例。2组患者均口服氯沙坦钾片,观察组患者在此基础上加用自拟消渴肾安汤,2组患者均治疗3个月。治疗结束后,采用《中药新药临床指导原则》评估2组患者治疗前、治疗3个月后中医证候积分。采集2组患者治疗前、治疗3个月后清晨空腹静脉血5 mL,离心取血清,应用全自动生化分析仪测定血清肌酐(SCr)、血尿素氮(BUN)水平,采用酶联免疫吸附法检测血清内皮素-1(ET-1)、可溶性细胞间黏附分子-1(sICAM-1)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平;采集2组患者治疗前、治疗3个月后尿液标本,应用全自动生化分析仪检测尿白蛋白、肌酐水平,并计算尿白蛋白肌酐比值(UACR),流式细胞仪测定足细胞podocin、nephrin水平。结果治疗前,2组患者五心烦热、形瘦食多、神疲乏力、水肿积分比较差异无统计学意义(P>0.05);治疗3个月后,2组患者五心烦热、形瘦食多、神疲乏力、水肿积分均显著低于治疗前,且观察组患者五心烦热、形瘦食多、神疲乏力、水肿积分均显著低于对照组(P<0.05)。治疗前,2组患者的SCr、BUN及尿液UACR水平比较差异无统计学意义(P>0.05);治疗3个月后,2组患者SCr、BUN及尿液UACR水平显著低于治疗前,且观察组患者SCr、BUN及尿液UACR水平显著低于对照组(P<0.05)。治疗前,2组患者尿液podocin、nephrin水平比较差异无统计学意义(P>0.05);治疗3个月后,2组患者尿液podocin、nephrin水平显著低于治疗前,且观察组患者尿液podocin、nephrin水平显著低于对照组(P<0.05)。治疗前,2组患者血清ET-1、sICAM-1水平比较差异无统计学意义(P>0.05);治疗3个月后,2组患者血清Objective To explore the effects of Xiaoke Shen′an decoction combined with losartan on renal vascular endothelial function and urine podocyte transmembrane protein level in patients with diabetic nephropathy(DN).Methods One hundred and two DN patients admitted to Wujin Hospital of TCM from March 2022 to December 2023 were selected as the research subjects,and according to the treatment method,they were randomly divided into observation group and control group,with 51 patients in each group.All patients in the two groups were given losartan potassium tablets orally,and patients in the observation group were additionally given self-proposed Xiaoke Shen′an decoction for three months.Traditional Chinese medicine symptom scores of patients in the two groups were evaluated before treatment and three months after treatment according to the Guiding Principles for Clinical Trials of New Chinese Medicines.A 5 mL fasting venous blood sample was collected from patients in both groups before treatment and three months after treatment,respectively.After centrifugation,the serum was obtained,and the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)were measured by using a fully automatic biochemical analyzer.The levels of serum endothelin-1(ET-1),soluble intercellular adhesion molecule-1(sICAM-1),superoxide dismutase(SOD)and malondialdehyde(MDA)were detected by using the enzyme-linked immunosorbent assay.Urine samples were collected from patients in both groups before treatment and three months after treatment,and the levels of urinary albumin and creatinine were detected by using a fully automatic biochemical analyzer;and the urinary albumin-to-creatinine ratio(UACR)was calculated.The levels of podocin and nephrin were measured by using flow cytometer.Results Before treatment,there was no statistically significant difference in restlessness,thinness&overeating,fatigue,and edema scores of patients between the two groups(P>0.05);three months after treatment,the restlessness,thinness&overeating,fatigue,and edema sco

关 键 词：糖尿病肾病 消渴肾安汤 血管内皮细胞 氧化应激 

分 类 号：R683.42[医药卫生—骨科学]