益肾养阴固精方对2型糖尿病肾病气阴两虚证患者TGF-β1、S1P、NLRP3炎症小体及胰岛β细胞功能的影响  

Effects of Yishen Yangyin Gujing Prescription on Transforming Growth Factorβ1,Sphingosine-1-Phosphate,NLRP3 Inflammasome and Pancreaticβ-cell Function of Type 2 Diabetic Mellitus Patients with Diabetic Nephropathy of Qi and Yin Deficiency Syndrome

作　　者：秦刚新 苏衍进 刘金响 赵莉 王惠铃 杨锦欣 QIN Gangxin;SU Yanjin;LIU Jinxiang;ZHAO Li;WANG Huiling;YANG Jinxin(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China;The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China)

机构地区：[1]陕西中医药大学附属医院,陕西咸阳712000 [2]陕西中医药大学第二附属医院,陕西咸阳712000

出　　处：《广州中医药大学学报》2025年第1期78-85,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：陕西省重点研发计划项目(编号:2020SF-336)。

摘　　要：【目的】探讨益肾养阴固精方(左归丸化裁)在2型糖尿病肾病气阴两虚证治疗中的应用价值,观察其对炎症反应、胰岛β细胞功能及肾功能的影响。【方法】将2020年5月至2023年7月在陕西中医药大学附属医院就诊的162例2型糖尿病肾病气阴两虚证患者按随机数字表法随机分为观察组和对照组,每组各81例。对照组给予降压、护肾等西医常规治疗,观察组在对照组的基础上联合益肾养阴固精方治疗,疗程为12周。观察2组患者治疗前后中医证候总积分、胰岛素敏感指数、胰岛素分泌指数、24 h尿蛋白定量(24hUTP)及血清糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹血糖(FBG)、血肌酐(SCr)、尿素氮(BUN)、转化生长因子β1(TGF-β1)、NLRP3炎症小体、白细胞介素6(IL-6)、超氧化物歧化酶(SOD)、1-磷酸鞘氨醇(S1P)水平的变化情况,并比较2组患者的临床疗效。【结果】(1)治疗12周后,观察组的总有效率为93.83%(76/81),对照组为83.95%(68/81),组间比较,观察组的疗效明显优于对照组(χ^(2)=9.163,P<0.05)。(2)治疗后,2组患者的胰岛素敏感指数、胰岛素分泌指数均较治疗前升高(P<0.05),中医证候总积分均较治疗前降低(P<0.05),且观察组对胰岛素敏感指数、胰岛素分泌指数的升高幅度及对中医证候总积分的降低幅度均明显优于对照组(P<0.05)。(3)治疗后,2组患者的血清HbA1c、FINS、FBG、SCr、BUN及24hUTP水平均较治疗前降低(P<0.05),且观察组对血清HbA1c、FINS、FBG、SCr、BUN及24hUTP水平的降低幅度均明显优于对照组(P<0.05)。(4)治疗后,2组患者的血清TGF-β1、IL-6、NLRP3炎症小体水平均较治疗前降低(P<0.05),血清S1P、SOD水平均较治疗前升高(P<0.05),且观察组对血清TGF-β1、IL-6、NLRP3炎症小体水平的降低幅度及对血清S1P、SOD水平的升高幅度均明显优于对照组(P<0.05)。【结论】对于2型糖尿病肾病气阴两虚证患者而言,联合益肾养阴�Objective To explore the efficacy of Yishen Yangyin Gujing Prescription[derived from Zuogui Wan(Bolus for Replenishing Kidney-Yin)]for the treatment of diabetic nephropathy in type 2 diabetes mellitus(T2DM)with qi and yin deficiency syndrome,and to observe its effects on inflammatory responses,pancreaticβ-cell function and renal function.Methods A total of 162 T2DM patients with diabetic nephropathy of qi and yin deficiency syndrome who admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine from May 2020 to July 2023 were randomly divided into an observation group and a control group according to the random number table method,with 81 cases in each group.The control group was given conventional western medicine treatment for lowering blood pressure and renal protection,while the observation group was treated with Yishen Yangyin Gujing Prescription on the basis of treatment for the control group.The course of treatment for the two groups covered 12 weeks.Before and after the treatment,the changes in the outcomes of the two groups were observed,and the outcomes included the total scores of traditional Chinese medicine(TCM)syndrome,insulin sensitivity index,insulin secretion index,24-h urine total protein quantification(24hUTP),and serum levels of glycosylated hemoglobin(HbA1c),fasting insulin(FINS),fasting blood glucose(FBG),serum creatinine(SCr),blood urea nitrogen(BUN),transforming growth factorβ1(TGF-β1),NLRP3 inflammasome,interleukin 6(IL-6),superoxide dismutase(SOD)and sphingosine-1-phosphate(S1P).After treatment,the clinical efficacy of the two groups of patients was compared.Results(1)After 12-week treatment,the total effective rate of the observation group was 93.83%(76/81),and that of the control group was 83.95%(68/81).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(χ^(2)=9.163,P<0.05).(2)After treatment,the insulin sensitivity index and insulin secretion index in the two groups of patients were

关 键 词：益肾养阴固精方 左归丸 2型糖尿病肾病 气阴两虚证 1-磷酸鞘氨醇 转化生长因子β1 NLRP3炎症小体 胰岛Β细胞功能 肾功能 

分 类 号：R259.872[医药卫生—中西医结合]