糖尿病肾病合并动脉粥样硬化患者中医证候与血清NLRP3、IL-1β、hs-CRP的相关性研究  

Study on Relationship between TCM Syndromes and Serum NLRP3,IL-1βand hs-CRP Levels in Patients with DKD and Atherosclerosis

作　　者：赵碧佳 朱晓鸥 沈金峰 ZHAO Bijia;ZHU Xiaoou;SHEN Jinfeng(Linhai Hospital of Chinese Medicine,Linhai,Zhejiang 317000;The First Hospital of Longyan,Longyan,Fujian 364000)

机构地区：[1]临海市中医院,浙江临海317000 [2]龙岩市第一医院,福建龙岩364000

出　　处：《中国中医药科技》2025年第3期397-400,433,共5页Chinese Journal of Traditional Medical Science and Technology

基　　金：福建省自然科学基金项目(2023J011898)。

摘　　要：目的:探讨糖尿病肾病(DKD)合并动脉粥样硬化(AS)患者中医证候与核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、白细胞介素-1β(IL-1β)、超敏C-反应蛋白(hs-CRP)的相关性。方法:选取符合纳入标准的糖尿病肾病合并动脉粥样硬化患者201例,对患者的年龄、性别、NLRP3、IL-1β、hs-CRP、中医证候分布进行统计学分析,并探讨中医证候与年龄、性别分布情况及NLRP3、IL-1β、hs-CRP的相关性。结果:①201例DKD合并AS患者中医证候分布从高到低依次为脾肾阳虚证>气阴两虚证>阴阳两虚证>浊毒阻脉证;②DKD合并AS辨证40~60岁气阴两虚证最多见,60岁以上脾肾阳虚证、阴阳两虚证、浊毒阻脉证多见;③4种中医证型男性皆高于女性;④气阴两虚证最多兼证为瘀血证,脾肾阳虚证最多兼证为水湿证,阴阳两虚证最多兼证为痰瘀证;浊毒阻脉证最多兼证为湿热证;⑤DKD合并AS患者NLRP3、IL-1β、hs-CRP水平从高到低中医证候排序为浊毒阻脉证>阴阳两虚证>脾肾阳虚证>气阴两虚证(P<0.05);⑥Logistic多因素回归分析显示,DKD合并AS患者NLRP3、IL-1β、hs-CRP水平与气阴两虚证、脾肾阳虚证、阴阳两虚证、浊毒阻脉证呈正相关(P<0.05)。结论:DKD合并AS患者中医证候分布与NLRP3、IL-1β、hs-CRP存在一定相关性,NLRP3、IL-1β、hs-CRP水平与病情程度呈一定相关性,NLRP3、IL-1β、hs-CRP有可能成为DKD合并AS中医辨证的潜在生物学指标。Objective:To investigate the relationship between TCM syndromes and serum NLRP3,IL-1βand hs-CRP levels in patients with diabetic kidney disease(DKD)complicated with atherosclerosis(AS).Methods:A total of 201 patients with diabetic kidney disease complicated with atherosclerosis who met the inclusion criteria were selected,and the distribution of age,gender,NLRP3,IL-1β,hs-CRP and TCM syndromes were statistically analyzed,and the distribution of TCM syndromes,age and gender in patients with diabetic nephropathy and their relationship with NLRP3,IL-1βand hs-CRP were discussed.Results:①The number of TCM syndromes in 201 patients with DKD and AS from high to low was spleen and kidney yang deficiency>qi and yin deficiency>yin and yang deficiency>turbidity and poison obstruction pulse.②Qi and yin deficiency syndrome of DKD combined with AS was the largest number of people at age of 40~60 years old,spleen and kidney yang deficiency,yin and yang deficiency,turbidity and poison obstruction pulse syndromes were common seen at age of 60 years old above.③TCM syndrome types were higher in males than in females.④The most common seen accompanying syndrome of qi and yin deficiency was blood stasis,the most common seen accompanying syndrome of spleen and kidney yang deficiency was water dampness,the most common seen accompanying syndrome of yin and yang deficiency was phlegm stasis.⑤The levels of serum NLRP3,IL-1βand hs-CRP in patients with DKD and AS from high to low in TCM syndromes were yin and yang deficiency>spleen and kidney yang deficiency>qi and yin deficiency(P<0.05).⑥Logistic multivariate regression analysis showed that the levels of NLRP3,IL-1βand hs-CRP in patients with DKD and AS were positively correlated with qi and yin deficiency syndrome,spleen and kidney yang deficiency syndrome,yin and yang deficiency syndrome,and turbidity and poison pulse obstruction syndrome(P<0.05).Conclusion:There is a certain correlation between the TCM syndromes and serum NLRP3,IL-1βand hs-CRP levels in patients with DKD

关 键 词：糖尿病肾病 动脉粥样硬化 中医证候 NLRP3 IL-1Β HS-CRP 相关性 

分 类 号：R259[医药卫生—中西医结合]