参芪地黄汤联合氯沙坦治疗早期糖尿病肾病的临床疗效及对血清中CRP、TNF-α和IL-6水平的影响
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摘要
目的探究参芪地黄汤联合氯沙坦对早期糖尿病肾病的临床疗效及对血清中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平的影响。方法选择2016年4月-2018年3月在我院接收治疗的早期糖尿病肾病患者90例作为研究对象,按照随机数字表法将研究对象分为对照组和研究组,每组45例。对照组在基础治疗的基础之上给予氯沙坦,研究组在对照组治疗的基础之上给予参芪地黄汤。对比两组患者治疗后总有效率,对比两组患者治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb Alc)、尿微量蛋白(m ALB)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)、收缩压(SBP)、舒张压(DBP)、CRP、TNF-α和IL-6水平。结果两组治疗后FBG、Hb Alc、m ALB、NAG,SBP、DBP、CRP、TNF-α和IL-6水平均显著低于本组治疗前(P <0. 05),研究组治疗后FBG、Hb Alc、m ALB、NAG、SBP、DBP、CRP、TNF-α和IL-6水平均显著低于对照组(P <0. 05)。结论参芪地黄汤和氯沙坦联合使用后可以显著地改善糖尿病肾病的症状,更显著地改善糖尿病肾病患者的炎症反应。
Objective To explore the influence of shenqi dihuang decoction and losartan on clinical therapeutic effects on early diabetic nephropathy( DN) and the levels of serum CRP,TNF-α and IL-6. Methods From April 2016 to March 2018,90 patients with early DN were collected as the subjects. According to random number table,they were divided into control group and a trial group,45 cases in each one. In the control group,besides the basic treatment,losartan was used. In the trial group,on the base of the treatment as the control group,shenqi dihuang decoction was added. The total effective rate was compared between the two groups after treatment. Before and after treatment,FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were compared in the two groups. Results After treatment,the levels of FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were all reduced significantly as compared with the levels before treatment in the self-comparison of each group( P < 0. 05). After treatment,in the trial group,the levels of FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were all lower significantly than the control group( P < 0. 05). Conclusion The co-medication of shenqi dihuang decoction and losartan improves in the conditions of DN,relieves inflammatory reactions and obtains the satisfactory clinical therapeutic effects in the DN patients.
Objective To explore the influence of shenqi dihuang decoction and losartan on clinical therapeutic effects on early diabetic nephropathy( DN) and the levels of serum CRP,TNF-α and IL-6. Methods From April 2016 to March 2018,90 patients with early DN were collected as the subjects. According to random number table,they were divided into control group and a trial group,45 cases in each one. In the control group,besides the basic treatment,losartan was used. In the trial group,on the base of the treatment as the control group,shenqi dihuang decoction was added. The total effective rate was compared between the two groups after treatment. Before and after treatment,FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were compared in the two groups. Results After treatment,the levels of FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were all reduced significantly as compared with the levels before treatment in the self-comparison of each group( P < 0. 05). After treatment,in the trial group,the levels of FBG,Hb Alc,m ALB,NAG,SBP,DBP,CRP,TNF-α and IL-6 were all lower significantly than the control group( P < 0. 05). Conclusion The co-medication of shenqi dihuang decoction and losartan improves in the conditions of DN,relieves inflammatory reactions and obtains the satisfactory clinical therapeutic effects in the DN patients.
引文
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[5]董艳芳,吕树泉,宋慧丽,等.中医分期辨治糖尿病肾病对血糖、肾功能指标的影响[J].现代中西医结合杂志,2018,27(11):1179-1181.
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[7]赵进喜,王世东,李靖,等.糖尿病肾脏病分期辨证规范与疗效评定方案及其研究[J].世界中医药,2017,12(1):1-4.
[8]杨辰华.分期分型辨治糖尿病肾病体会[J].中医研究,2017,30(11):45-47.
[9]何娅妮,张炜炜.肾病综合征的流行病学现状[J].中华肾病研究电子杂志,2017,6(4):149-153.
[10]Khan MI,Siddique KU,Ashfaq F,et al. Effect of high-dose zinc supplementation with oral hypoglycemic agents on glycemic control and inflammation in type-2 diabetic nephropathy patients[J].Journal of Natural Science Biology&Medicine,2013,4(2):336-344.
[11]余晓波,余永壮.糖尿病肾病的发病机制及治疗进展[J].中国临床新医学,2017,10(10):1022-1025.
[12]李斌,张跃,郭兵.肾炎舒颗粒联合氯沙坦治疗早期糖尿病肾病的疗效及对血清炎症因子的影响[J].重庆医学,2015,44(34):4835-4837.
[13]曾黄辉,石锋. 2型糖尿病肾病不同时期血清TNF-α、hsCRP水平变化和硫辛酸的干预效果[J].海峡药学,2018,30(6):109-110.
[14]高芃,刘晓刚.白细胞介素6信号转导通路与糖尿病肾病的关系[J].医学综述,2018,24(10):2043-2047.
[15]杨宏秀,张会芬,刘丽,等.血清NGAL、TRF、hs-CRP及SF在糖尿病肾病诊断中的价值[J].山东医药,2017,57(46):50-52.
[2]陈锐,聂海洋,陈锦英,等.糖尿病肾病机制的中西医研究进展[J].中国老年学杂志,2014,34(22):6515-6516.
[3]Ah YM,Lee JY,Choi YJ,et al. Influence of initial angiotensin receptor blockers on treatment persistence in uncomplicated hyper-tension:A nation-wide population-based study[J]. Clin Exp Hypertens,2016,30(1):1-6.
[4]李玉芝. 2型糖尿病合并糖尿病肾脏病的治疗进展[J].中国城乡企业卫生,2018,33(6):38-40.
[5]董艳芳,吕树泉,宋慧丽,等.中医分期辨治糖尿病肾病对血糖、肾功能指标的影响[J].现代中西医结合杂志,2018,27(11):1179-1181.
[6]邬明辉,杨晓丽,韩秋霞,等.糖尿病肾病研究进展[J].中华肾病研究电子杂志,2018,7(2):86-90.
[7]赵进喜,王世东,李靖,等.糖尿病肾脏病分期辨证规范与疗效评定方案及其研究[J].世界中医药,2017,12(1):1-4.
[8]杨辰华.分期分型辨治糖尿病肾病体会[J].中医研究,2017,30(11):45-47.
[9]何娅妮,张炜炜.肾病综合征的流行病学现状[J].中华肾病研究电子杂志,2017,6(4):149-153.
[10]Khan MI,Siddique KU,Ashfaq F,et al. Effect of high-dose zinc supplementation with oral hypoglycemic agents on glycemic control and inflammation in type-2 diabetic nephropathy patients[J].Journal of Natural Science Biology&Medicine,2013,4(2):336-344.
[11]余晓波,余永壮.糖尿病肾病的发病机制及治疗进展[J].中国临床新医学,2017,10(10):1022-1025.
[12]李斌,张跃,郭兵.肾炎舒颗粒联合氯沙坦治疗早期糖尿病肾病的疗效及对血清炎症因子的影响[J].重庆医学,2015,44(34):4835-4837.
[13]曾黄辉,石锋. 2型糖尿病肾病不同时期血清TNF-α、hsCRP水平变化和硫辛酸的干预效果[J].海峡药学,2018,30(6):109-110.
[14]高芃,刘晓刚.白细胞介素6信号转导通路与糖尿病肾病的关系[J].医学综述,2018,24(10):2043-2047.
[15]杨宏秀,张会芬,刘丽,等.血清NGAL、TRF、hs-CRP及SF在糖尿病肾病诊断中的价值[J].山东医药,2017,57(46):50-52.