黄芪桂枝五物汤加减联合前列地尔治疗糖尿病肾病患者的临床疗效及对其血清转化生长因子-β1、单核细胞趋化蛋白-1水平的影响  

Clinical Efficacy of Huangqi Guizhi Wuwu Decoction with Alprostadil on Diabetes Nephropathy and Effect on Serum TGF-β1,and MCP-1 Levels

作　　者：陈海莺[1] 熊丹 肖丹 徐勇[3] CHEN Hai-ying;XIONG Dan;XIAO Dan;XU Yong(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha Hunan 41007;Changsha Jieao Hospital,Changsha Hunan 410026;The Third Xiangya Hospital of Central South University,Changsha Hunan 410013)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙41007 [2]长沙捷奥医院,湖南长沙410026 [3]中南大学湘雅三医院,湖南长沙410013

出　　处：《世界中西医结合杂志》2025年第3期563-567,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：湖南2020年度创新型省份建设专项自然科学基金项目(2020JJ5439)。

摘　　要：目的探讨黄芪桂枝五物汤加减联合前列地尔治疗糖尿病肾病(Diabetic nephropathy,DN)的疗效及对血清转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、单核细胞趋化蛋白-1(Monocyte chemoattractant protein-1,MCP-1)的影响。方法选取2020年1月—2023年1月期间湖南中医药大学第一附属医院收治的DN患者120例,按随机数字表法分为对照组和观察组,每组各60例。对照组给予前列地尔治疗,观察组在对照组治疗基础上联合黄芪桂枝五物汤。均持续治疗21 d。观察比较两组患者临床疗效,同时评估其治疗前后中医证候积分,另外测定两组患者肾功能指标[24 h尿蛋白排泄率(Urinary albumin excretion rate,UAER)、尿β2微球蛋白(Urinaryβ2-microglobulin,β2-MC)、血尿素氮(Blood urea nitrogen,BUN)、血肌酐(Creatinine,Cr)]以及血清TGF-β1、MCP-1水平,最后比较两组患者不良反应发生情况。结果治疗后观察组临床总有效率93.33%(56/60)高于对照组83.33%(50/60),差异有统计学意义(P<0.05)。治疗后两组患者咽干口燥、倦怠乏力、气短懒言、心悸失眠、舌红少津液、脉细数积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者UAER、β2-MC、BUN、Cr均较治疗前降低,差异有统计学意义(P<0.05);且观察组肾功能各指标低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清TGF-β1、MCP-1水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血清TGF-β1、MCP-1水平低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论黄芪桂枝五物汤加减联合前列地尔治疗DN疗效显著,能有效改善患者临床症状、体征以及肾功能,同时还能调节其血清TGF-β1、MCP-1水平,具有一定安全性。Objective To explore the clinical efficacy of Huangqi Guizhi Wuwu decoction combined with alprostadil on diabetic nephropathy(DN),and the effect on serum growth factor beta 1(TGF-β1)and monocyte chemoattractant protein-1(MCP-1).Methods 120 patients with DN admitted to the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2020 to January 2023 were selected as the study objects.They were divided into a control group and an observation group by random number table method,with 60 cases in each group.The control group was treated with alprostadil,and the observation group was additionally given Huangqi Guizhi Wuwu decoction.All patients were treated for 21 days.The following aspects were observed and compared before and after treatment in both groups:clinical efficacy,the traditional Chinese medicine(TCM)syndrome scores,renal function indexes[24-hour urinary albumin excretion rate(UAER),urinaryβ2-microglobulin(β2-MC),blood urea nitrogen(BUN),creatinine(Cr)],serum TGF-β1 and MCP-1 levels,as well as the occurrence of adverse reactions.Results After treatment,the total clinical efficacy of the observation group was 93.33%(56/60),higher than that of control group 83.33%(50/60),and the difference was statistically significant(P<0.05).The scores were decreased in both groups of dry throat and mouth,fatigue,shortness of breath and disinclination to talk,palpitation and insomnia,red tongue and insufficient body fluid,as well as thready and rapid pulse(P<0.05).The TCM syndrome score of the observation group was lower than that of the control group(P<0.05).UAER,β2-MC,BUN,and Cr in the 2 groups were reduced(P<0.05),with the results lower in the observation group(P<0.05).Besides,the serum TGF-β1 and MCP-1 levels in the 2 groups were decreased(P<0.05),with the levels of TGF-β1 and MCP-1 lower in the observation group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Huangqi Guizhi Wuwu decoction combined with alprost

关 键 词：黄芪桂枝五物汤 前列地尔 糖尿病肾病 转化生长因子-β1 单核细胞趋化蛋白-1 

分 类 号：R58[医药卫生—内分泌]