保肾通络方治疗糖尿病肾脏病气阴两虚兼血瘀证疗效及对患者血清isthmin-1水平的影响  

Research of Baoshen Tongluo decoction on serum isthmin-1 of diabetic kidney disease with qi yin deficiency and blood stasis

作　　者：王晖[1] 赵文景[1] 孟元[1] 王悦芬[1] 蔡朕[1] 郑桂敏[1] 江心灿 崔方强 WANG Hui;ZHAO Wenjing;MENG Yuan;WANG Yuefen;CAI Zhen;ZHENG Guimin;JIANG Xincan;CUI Fangqiang(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《陕西中医》2025年第5期620-623,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81703989);北京市属医院科研培育计划(PZ2025012);北京市属医院科研培育计划项目(PZ2019013);首都医科大学科研培育基金(自然类)资助项目(PYZ22163)。

摘　　要：目的:观察保肾通络方对于气阴两虚兼血瘀证糖尿病肾脏病(DKD)患者的临床疗效及其对患者血清isthmin-1表达、尿足细胞数目的影响。方法:收集DKD(G2A3期)患者60例,随机分为治疗组和对照组,两组患者均给予饮食控制、降糖、降压等基础治疗,而治疗组在基础治疗的同时加服保肾通络方,干预12周,后对两组患者治疗前后24 h尿蛋白(24 h UTP)、尿白蛋白肌酐比(ACR)、血清肌酐(Scr)、血清尿素氮(BUN)、肾小球滤过率(eGFR)、中医证候积分、尿足细胞数目及血清isthmin-1水平进行比较。结果:治疗组总有效率明显高于对照组(P<0.05),两组患者经治疗后,治疗组患者的24 h UTP、尿ACR、血清肌酐、血清尿素氮及中医证候积分均较对照组明显降低(P<0.01),eGFR明显升高(P<0.01)。与对照组相比,治疗组患者治疗后的尿足细胞数目及血清isthmin-1水平明显降低(P<0.01)。结论:保肾通络方可以降低DKD患者蛋白尿、保护肾功能,同时可以降低血清isthmin-1水平及减少尿足细胞数目。Objective:To observe the effect of Baoshen Tongluo decoction on serum isthmin-1 and urinary podocytes of diabetic kidney disease patients.Methods:A total of 60 DKD(G2A3)patients were randomly divided into control group and treatment group.Patients in control group were received with basic treatment.Patients in treatment group were received with Baoshen Tongluo decoction on along with basic treatment.The treatments were lasted for 12 weeks.Scr,BUN,UACR,24 h UTP,eGFR,serum isthmin-1 and urinary podocytes were detected.Clinical symptom scores and therapeutic efficacy were compared between the two groups before and after treatment.Results:The total effective rate of treatment group was higher than that in the control group(P<0.05).After treatment,the scores of TCM symptoms,24 h UTP,UACR,Scr,and BUN were lower in the treatment group than those in the control group(P<0.01).Compared with control group,eGFR was significantly increased in treatment group after the treatment(P<0.01).After the treatment,the level of serum isthmin-1 and urinary podocytes were significantly decreased in treatment group compared with control group(P<0.01).Conclusion:Baoshen Tongluo decoction on can significantly decrease proteinuria and improved renal function in DKD,partly via decreasing serum isthmin-1 and urinary podocytes of DKD.

关 键 词：糖尿病肾脏病 终末期肾病 保肾通络方 尿素氮 血清Ism-1 尿足细胞 

分 类 号：R587.2[医药卫生—内分泌]