健脾活血祛风方治疗糖尿病肾病的临床疗效及对免疫功能的影响  

Clinical Effect of Jianpi Huoxue Qufeng(健脾活血祛风)Decoction on Diabetic Nephropathy and Its Influence on Immune Function

作　　者：陈杰[1,3] 郭玥 刘伟伟 廖琳 刘文瑞[1] 段连香[1] 陈文浩 刘子洋 胡静 张传富[2,3] 沈翌迪 路建饶[1,3] 叶景华 CHEN Jie;GUO Yue;LIU Weiwei;LIAO Lin;LIU Wenrui;DUAN Lianxiang;CHEN Wenhao;LIU Ziyang;HU Jing;ZHANG Chuanfu;SHEN Yidi;LU Jianrao;YE Jinghua(Department of Nephrology of the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137;Department of Rheumatology and Immunology of the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137;Ye Jinghua National Famous Traditional Chinese Medicine Studio,Shanghai 200137)

机构地区：[1]上海中医药大学附属第七人民医院肾病科,上海200137 [2]上海中医药大学附属第七人民医院风湿免疫科,上海200137 [3]叶景华全国名老中医工作室,上海200137

出　　处：《中药药理与临床》2024年第11期71-75,共5页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家自然科学基金(编号:82074261);上海市浦东新区卫健委面上项目(编号:PW2022A-73);上海市浦东新区临床中医高峰学科(编号:PDZY-2018-0601)。

摘　　要：目的:观察健脾活血祛风方对糖尿病肾病的临床疗效及对免疫功能的影响。方法:选取糖尿病肾病Ⅲ-Ⅳ患者120例,随机分为两组,两组均给予降压、降糖等基础治疗,对照组给予氯沙坦钾100 mg/d口服,治疗组在对照组的基础上予健脾活血祛风方口服,2次/d,150 mL/次,总疗程3个月,比较治疗前后两组的中医证候评分、总有效率、空腹血糖、糖化血红蛋白、24 h蛋白尿定量、尿微量白蛋白、尿白蛋白/肌酐比值、补体(C3、C3a、C5)、T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))等。结果:与治疗前比较,对照组治疗后倦怠乏力、食少纳呆、脘腹胀满、口中粘腻、水肿、心悸气短、手足麻木、失眠健忘的积分及总积分均降低(P<0.05),治疗组倦态乏力、食少纳呆、恶心呕吐、脘腹胀满、口中粘腻、口干口苦、腰膝酸软、肢体困重、水肿、心悸气短、手足麻木、失眠健忘的积分及总积分均降低(P<0.05);治疗后,与对照组比较,治疗组倦怠乏力、食少纳呆、恶心呕吐、脘腹胀满、口中粘腻、口干口苦、腰膝酸软的积分及总积分均降低(P<0.05);治疗后治疗组总有效率优于对照组(P<0.05)。与治疗前比较,两组24 h蛋白尿定量、尿微量白蛋白及尿白蛋白/肌酐比值均降低(P<0.05),C3、C3a、C5含量降低(P<0.05),CD3^(+)、CD8^(+)均降低、CD4^(+)、CD4^(+)/CD8^(+)均上升(P<0.05);治疗后,与对照组比较,治疗组24 h蛋白尿定量、尿微量白蛋白及尿白蛋白/肌酐比值均降低(P<0.05)、C3、C3a、C5含量降低(P<0.05),CD3^(+)、CD8^(+)均降低,CD4^(+)、CD4^(+)/CD8^(+)升高(P<0.05)。结论:健脾活血祛风方能够改善糖尿病肾病患者症状,减少尿蛋白,其作用机制并非通过调节血糖,可能通过改善免疫功能,达到延缓糖尿病肾病进展的疗效。Objective:To observe the clinical effect of Jianpi Huoxue Qufeng(健脾活血祛风)Decoction on diabetic nephropathy and its influence on immune function.Methods:A total of 120 patients with diabetic nephropathy Ⅲ-Ⅳ were selected and randomly divided into two groups.Both groups were given basic treatment such as blood pressure and glucose reduction.Patients in the control group were given losartan potassium of 100 mg/day orally,and those in the treatment group were given Jianpi Huoxue Qufeng Decoction orally based on the control group twice a day,with 150 mL each time for three months.The traditional Chinese medicine(TCM)syndrome score,total effective rate,fasting blood glucose,glycosylated hemoglobin,24-hour proteinuria,microalbuminuria,urinary albumin/creatinine ratio,complements(C3,C3a,and C5),T cell subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),etc were compared after and before treatment.Results:After treatment,the scores and total scores of the control group were decreased(P<0.05)in terms of fatigue,lack of food intake,fullness of epigastric distension,greasy mouth,edema,palpitations,shortness of breath,numbness of hands and feet,insomnia,and forgetfulness.After treatment,the scores and total scores of the treatment group were decreased in terms of fatigue,lack of food intake,nausea and vomiting,fullness of epigastric distension,greasy mouth,dry mouth,bitter mouth,sore waist and knees,heavy limbs,edema,shortness of breath,palpitations,numbness of hands and feet,insomnia,and forgetfulness(P<0.05).After treatment,compared with those of the control group,the scores and total scores of the treatment group were decreased in terms of fatigue,lack of food intake,nausea and vomiting,fullness of epigastric distension,greasy mouth,dry mouth,bitter mouth,and weak waist and knees(P<0.05),while the total effective rate of the treatment group was better than that of the control group(P<0.05).After treatment,there were no significant changes in fasting blood glucose and glycosylated hemoglobin in both groups(P>0.0

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分 类 号：R25[医药卫生—中医内科学]