木丹颗粒联合己酮可可碱治疗2型糖尿病合并早期肾脏病的临床效果  

Clinical effect of Mudan Granules combined with pentoxifylline in treatment of type 2 diabetes mellitus combined with early renal disease

作　　者：陈丹丹[1] 罗俊辉[2] 张海涛[1] 夏萃 CHEN Dandan;LUO Junhui;ZHANG Haitao;XIA Cui(Department of Endocrinology,the Second People′s Hospital of Hunan Province,Changsha,Hunan,410000;Department of Nephrology,the Second People′s Hospital of Hunan Province,Changsha,Hunan,410000)

机构地区：[1]湖南省第二人民医院内分泌科,湖南长沙410000 [2]湖南省第二人民医院肾内科,湖南长沙410000

出　　处：《实用临床医药杂志》2024年第24期116-120,共5页Journal of Clinical Medicine in Practice

基　　金：湖南省创新型省份建设专项项目(S2022JJZZLH01825)。

摘　　要：目的探讨木丹颗粒联合己酮可可碱治疗2型糖尿病(T2DM)合并早期肾脏病的临床效果,并分析其对Toll样受体4(TLR4)/核转录因子-κB(NF-κB)信号通路的影响。方法选取2022年5月—2023年10月湖南省第二人民医院收治的164例T2DM合并早期肾脏病患者为研究对象,采用随机数字表法按照1∶1配对原则将其分为观察组(n=82)、对照组(n=82)。对照组接受己酮可可碱治疗,观察组接受木丹颗粒联合己酮可可碱治疗。比较2组临床疗效以及治疗前后肾功能指标[血肌酐(SCr)、尿素氮、尿白蛋白肌酐比值(UACR)]、TLR4/NF-κB信号通路指标(TLR4、MyD88、NF-κB mRNA)、炎症与氧化应激指标[C反应蛋白(CRP)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)、总抗氧化能力(TAC)及转化生长因子β1(TGF-β1)]变化。结果观察组治疗总有效率为97.56%,高于对照组的89.02%,差异有统计学意义(P<0.05)。治疗6、12周时,2组SCr、尿素氮、UACR水平较治疗前下降,且观察组以上指标水平均低于对照组,差异有统计学意义(P<0.05)。治疗6、12周时,2组TLR4、MyD88、NF-κB mRNA水平较治疗前下降,且观察组以上指标水平低于对照组,差异有统计学意义(P<0.05)。治疗6、12周时,2组GSH-PX、TAC水平较治疗前升高,CRP、MDA、TGF-β1水平较治疗前下降,且观察组GSH-PX、TAC水平高于对照组,CRP、MDA水平低于对照组,差异有统计学意义(P<0.05)。结论木丹颗粒联合己酮可可碱治疗T2DM合并早期肾脏病可一定程度改善肾功能,调节TLR4/NF-κB信号通路,减轻炎症与氧化应激反应,有利于控制病情。Objective To investigate the clinical effect of Mudan Granules combined with pentoxifylline in the treatment of type 2 diabetes mellitus(T2DM)with early renal disease and analyze its impact on the Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway.Methods A total of 164 patients with T2DM and early renal disease admitted to the Second People′s Hospital of Hunan Province between May 2022 and October 2023 were enrolled and randomly divided into observation group(n=82)and control group(n=82)using a random number table in a 1-to-1 ratio.The control group received pentoxifylline treatment,while the observation group received Mudan granules combined with pentoxifylline.The clinical effects and changes in renal function indicators[serum creatinine(SCr),urea nitrogen,urinary albumin-to-creatinine ratio(UACR)],TLR4/NF-κB signaling pathway indicators(TLR4,MyD88,NF-κB mRNA),and inflammation and oxidative stress indicators[C-reactive protein(CRP),glutathione peroxidase(GSH-PX),malondialdehyde(MDA),total antioxidant capacity(TAC),and transforming growth factorβ1(TGF-β1)]before and after treatment were compared between the two groups.Results The total effective rate in the observation group was 97.56%,which was higher than 89.02%in the control group(P<0.05).At 6 and 12 weeks after treatment,the levels of SCr,urea nitrogen,and UACR in both groups decreased compared with those before treatment,and the levels of these indicators in the observation group were lower than those in the control group(P<0.05).At 6 and 12 weeks after treatment,the levels of TLR4,MyD88,and NF-κB mRNA in both groups decreased compared with those before treatment,and the levels of these indicators in the observation group were lower than those in the control group(P<0.05).At 6 and 12 weeks after treatment,the levels of GSH-PX and TAC in both groups increased,while the levels of CRP,MDA,and TGF-β1 decreased compared with those before treatment.The levels of GSH-PX and TAC in the observation group were higher than those in the con

关 键 词：己酮可可碱 木丹颗粒 2型糖尿病 TOLL样受体4 核转录因子-ΚB 

分 类 号：R692.5[医药卫生—泌尿科学] R587.1[医药卫生—外科学] R242[医药卫生—临床医学]