灯盏生脉胶囊治疗糖尿病肾病气阴两虚夹瘀证的疗效观察及其对血清IL-17A FGF-23水平的调节作用
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摘要
目的:观察灯盏生脉胶囊治疗气阴两虚夹瘀型糖尿病肾病(DN)的疗效,探讨其作用机制。方法:DN患者108例,按随机数字表法随机分为对照组和观察组,每组各54例。两组患者均采取常规干预措施,对照组给予还原型谷胱甘肽注射液治疗,观察组在对照组治疗基础上口服灯盏生脉胶囊,每次2粒,每天3次。治疗12周后评价疗效,比较两组患者治疗前后症状评分、肾功能变化以及血清IL-17A和FGF-23水平。结果:治疗12周后,观察组总有效率(92. 6%)高于对照组(75. 9%),差异有统计学意义(P <0. 05);观察组患者的症状评分以及血清肌酐(SCr)、血尿素氮(BUN)和24 h尿总蛋白、24 h尿清蛋白以及尿β2微球蛋白(β2-MG)低于对照组,差异有统计学意义(P <0. 05)。治疗12周后,观察组患者血清IL-17A水平高于对照组及FGF-23水平显著低于对照组(P <0. 05)。结论:在常规干预措施基础上加用灯盏生脉胶囊治疗气阴两虚夹瘀型DN,可促进临床症状和肾功能改善,提高临床疗效,且可调节患者体内IL-17A和FGF-23水平。
Objective:To observe the curative effect of Dengzhan Shengmai Capsule in treatment of diabetic nephropathy( DN) with syndrome of qi-yin deficiency and blood stasis,and investigate the mechanism.Methods:108 cases with DN were chosen and randomly divided into control group and observation group with each 54 cases.All patients were treated with routine therapy by referring to "Diabetic nephropathy expert consensus".Cases in the control group received remodel glutathione intravenous drip( 1.8 g/time and qd).On basis of control group,cases of the observation group received Dengzhan Shengmai Capsule( 2 grains/time and tid).After 12 weeks' treatment,the curative effect was evaluated,scores of symptoms,renal function and serum levels of IL-17A and FGF-23 were compared between the two groups.Results:After 12 weeks' treatment,total effective rate in the observation group( 92.6 %) was obviously higher than that in the control group( 75.9%)( P <0.05),scores of symptoms and serum creatinine( SCr),blood BUN,24 h total urine protein,24 h albumin,and urinary β2-MG were lowered,and the differences between the two groups were statistically significant( P <0.05).Serum level of IL-17A in the observation group was raised,while FGF-23 was lowered after 12 weeks' treatment,and the differences between the two groups were statistically significant( P < 0.01).Conclusion:Dengzhan Shengmai Capsule can promote improvement of clinical symptoms and renal function,raise the efficacy,regulate levels of serum IL-17 A and FGF-23 in DN with syndrome of qi-yin deficiency and blood stasis.
Objective:To observe the curative effect of Dengzhan Shengmai Capsule in treatment of diabetic nephropathy( DN) with syndrome of qi-yin deficiency and blood stasis,and investigate the mechanism.Methods:108 cases with DN were chosen and randomly divided into control group and observation group with each 54 cases.All patients were treated with routine therapy by referring to "Diabetic nephropathy expert consensus".Cases in the control group received remodel glutathione intravenous drip( 1.8 g/time and qd).On basis of control group,cases of the observation group received Dengzhan Shengmai Capsule( 2 grains/time and tid).After 12 weeks' treatment,the curative effect was evaluated,scores of symptoms,renal function and serum levels of IL-17A and FGF-23 were compared between the two groups.Results:After 12 weeks' treatment,total effective rate in the observation group( 92.6 %) was obviously higher than that in the control group( 75.9%)( P <0.05),scores of symptoms and serum creatinine( SCr),blood BUN,24 h total urine protein,24 h albumin,and urinary β2-MG were lowered,and the differences between the two groups were statistically significant( P <0.05).Serum level of IL-17A in the observation group was raised,while FGF-23 was lowered after 12 weeks' treatment,and the differences between the two groups were statistically significant( P < 0.01).Conclusion:Dengzhan Shengmai Capsule can promote improvement of clinical symptoms and renal function,raise the efficacy,regulate levels of serum IL-17 A and FGF-23 in DN with syndrome of qi-yin deficiency and blood stasis.
引文
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[6]韩晶晶,陈霞波,龚文波,等.参芪地黄汤联合缬沙坦治疗早期气阴两虚型糖尿病肾病的临床疗效观察[J].中华中医药学刊,2015,33(4):986-990.
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[8]Mohamed R,Jayakumar C,Chen F,et al.Low-dose IL-17 therapy prevents and reverses diabetic nephropathy,metabolic syndrome,and associated organ fibrosis[J].JAm Soc Nephrol,2016,27(3):745-765.
[9]刘静静,任伟,王科,等.糖尿病肾病尿毒症患者成纤维细胞生长因子23和骨保护素与桡动脉血管钙化的相关性[J].中国临床保健杂志,2016,19(2):177-180.
[10]罗俊华,李曙平,吴娜.早期2型糖尿病肾病患者成纤维细胞生长因子水平的变化及意义[J].检验医学与临床,2014,11(22):3123-3125.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):899-907.
[3]中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案)[J].上海中医药杂志,2007,41(7):7-8.
[4]中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792-801.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:233-237.
[6]韩晶晶,陈霞波,龚文波,等.参芪地黄汤联合缬沙坦治疗早期气阴两虚型糖尿病肾病的临床疗效观察[J].中华中医药学刊,2015,33(4):986-990.
[7]周焰.低剂量白细胞介素17A对糖尿病肾病大鼠肾功能保护作用的研究[J].标记免疫分析与临床,2017,24(3):282-286.
[8]Mohamed R,Jayakumar C,Chen F,et al.Low-dose IL-17 therapy prevents and reverses diabetic nephropathy,metabolic syndrome,and associated organ fibrosis[J].JAm Soc Nephrol,2016,27(3):745-765.
[9]刘静静,任伟,王科,等.糖尿病肾病尿毒症患者成纤维细胞生长因子23和骨保护素与桡动脉血管钙化的相关性[J].中国临床保健杂志,2016,19(2):177-180.
[10]罗俊华,李曙平,吴娜.早期2型糖尿病肾病患者成纤维细胞生长因子水平的变化及意义[J].检验医学与临床,2014,11(22):3123-3125.