雷公藤多苷联合复方α-酮酸对糖尿病肾病肾间质纤维化及氧化应激的影响
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摘要
目的探讨雷公藤多苷联合复方α-酮酸治疗糖尿病肾病(DN)的疗效及对肾间质纤维化及氧化应激的影响。方法选择医院2014年1月至2017年5月收治的DN患者93例,随机分为对照组(46例)和治疗组(47例)。对照组患者给予雷公藤多苷治疗,治疗组患者给予雷公藤多苷联合复方α-酮酸治疗,两组均连续治疗3个月。结果治疗组总有效率为93. 62%,明显高于对照组的78. 26%(χ2=4. 559,P=0. 033)。治疗后,两组患者血肌酐(SCr)、尿素氮(BUN)、胱抑素C(CysC)、24 h尿蛋白定量、血管内皮生长因子(VEGF)、同型半胱氨酸(Hcy)、转化生长因子-β1(TGF-β1)、丙二醛(MDA)、晚期蛋白氧化产物(AOPP)水平相比治疗前均降低,且治疗组降幅更明显(P <0. 05);两组患者肝细胞生长因子(HGF)、超氧化物歧化酶(SOD)及总抗氧化能力(T-AOC)水平相比治疗前均上升,且治疗组升幅更明显(P <0. 05)。两组治疗过程中不良反应发生率比较,差异无统计学意义(χ2=0. 595,P=0. 440)。结论雷公藤多苷联合复方α-酮酸治疗DN的临床疗效显著,能改善肾功能,抑制肾间质纤维化,减轻氧化应激反应,且安全性较好,值得临床推广。
Objective To investigate the clinical effect of tripterygium glycosides combined with compound α-keto acid in the treatment of diabetic nephropathy( DN) and its effect on renal interstitial fibrosis and oxidative stress. Methods Totally 93 patients with DN admitted to our hospital from January 2014 to May 2017 were selected and randomly divided into the control group( 46 cases) and the treatment group( 47 cases). The control group was treated with tripterygium glycosides, while the treatment group was treated with tripterygium glycosides combined with compound α-keto acid. The two groups were treated for 3 months. Results The total effective rate of the treatment group was 93. 62%,which was significantly higher than 78. 26% of the control group( χ2= 4. 559, P = 0. 033).After treatment,the levels of serum creatinine( SCr),blood urea nitrogen( BUN),cystatin C( CysC),24 h urinary protein quantification,vascular endothelial growth factor( VEGF), homocysteine( Hcy), transforming growth factor-β1( TGF-β1), malondialdehyde( MDA) and advanced oxidation protein products( AOPP) in the two groups were lower than those before treatment, and the decrease in the treatment group was more significant( P < 0. 05). While the levels of hepatocyte growth factor( HGF),superoxide dismutase( SOD) and total antioxidant capacity( T-AOC) in the two groups were higher than those before treatment, and the increase in the treatment group was more significant( P < 0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( χ2= 0. 595, P = 0. 440). Conclusion Tripterygium glycosides combined with compound α-keto acid is effective in the treatment of DN, it can improve renal function, inhibit renal interstitial fibrosis and reduce oxidative stress. It is safe and worthy of clinical promotion.
Objective To investigate the clinical effect of tripterygium glycosides combined with compound α-keto acid in the treatment of diabetic nephropathy( DN) and its effect on renal interstitial fibrosis and oxidative stress. Methods Totally 93 patients with DN admitted to our hospital from January 2014 to May 2017 were selected and randomly divided into the control group( 46 cases) and the treatment group( 47 cases). The control group was treated with tripterygium glycosides, while the treatment group was treated with tripterygium glycosides combined with compound α-keto acid. The two groups were treated for 3 months. Results The total effective rate of the treatment group was 93. 62%,which was significantly higher than 78. 26% of the control group( χ2= 4. 559, P = 0. 033).After treatment,the levels of serum creatinine( SCr),blood urea nitrogen( BUN),cystatin C( CysC),24 h urinary protein quantification,vascular endothelial growth factor( VEGF), homocysteine( Hcy), transforming growth factor-β1( TGF-β1), malondialdehyde( MDA) and advanced oxidation protein products( AOPP) in the two groups were lower than those before treatment, and the decrease in the treatment group was more significant( P < 0. 05). While the levels of hepatocyte growth factor( HGF),superoxide dismutase( SOD) and total antioxidant capacity( T-AOC) in the two groups were higher than those before treatment, and the increase in the treatment group was more significant( P < 0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( χ2= 0. 595, P = 0. 440). Conclusion Tripterygium glycosides combined with compound α-keto acid is effective in the treatment of DN, it can improve renal function, inhibit renal interstitial fibrosis and reduce oxidative stress. It is safe and worthy of clinical promotion.
引文
[1]罗加凯,李志红,尹飞,等.糖尿病肾病的临床特征及其危险因素研究[J].临床荟萃,2017,32(9):763-766.
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[5]邹顺,班立丽,冯莉嵋,等.复方α-酮酸片治疗2型糖尿病合并早期糖尿病肾病的临床观察[J].中国药房,2017,28(35):4981-4983.
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[9]朱俊.细胞因子在糖尿病肾病发生、发展过程中的作用[J].河北医药,2017,39(15):2369-2371.
[10]蒯巧林.雷公藤多苷治疗糖尿病肾病的效果和安全性[J].中外医学研究,2017,15(26):10-11.
[11]张敏,王璐.复方α酮酸辅助治疗对早期糖尿病肾病患者血清肾功能指标以及营养状态的影响[J].海南医学院学报,2016,22(21):2558-2561.
[12]刘凌汐,于洋.雷公藤多苷片联合复方α-酮酸片治疗糖尿病肾病的临床观察[J].中国药房,2017,28(33):4654-4657.
[13]陈卫东.肾炎康复联合雷公藤多苷对早期糖尿病肾病炎性因子及肾功能的影响[J].实用糖尿病杂志,2017,13(5):45-46.
[14]费沛,张庆红,胡兆雄.雷公藤多苷联合酮酸低蛋白饮食对老年糖尿病肾病患者肾功能的影响[J].现代中西医结合杂志,2016,25(17):1882-1884.
[15]廖涛生,冯涛,刘炳贤,等.肾小球滤过率与血清VEGF、胆红素水平在糖尿病肾病中的关系研究[J].标记免疫分析与临床,2017,24(11):1263-1268.
[16]何凌志,龙峥嵘. Cys-C、hs-CRP和Hcy联合检测对糖尿病肾病的早期诊断价值[J].吉林医学,2017,38(12):2335-2337.
[17]热孜万古丽·阿布都拉,宋雪.厄贝沙坦联合阿托伐他汀治疗对早期糖尿病肾病患者血清Cys C、Hcy、TNF-α、ET、TGF-b1水平的影响[J].海南医学院学报,2017,23(20):2776-2782.
[18]姚玉红,郭莉阁.糖肾宁对气阴两虚夹瘀型早期糖尿病肾病患者HGF,CysC和TGF-β1水平的影响[J].中国实验方剂学杂志,2015,21(12):139-142.
[19]翟海峰.雷公藤提取物联合α酮酸对糖尿病肾病患者血清同型半胱氨酸及血管内皮生长因子水平的影响[J].中国医药科学,2017,7(16):44-47.
[2]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.
[3]阮一平.糖尿病肾病治疗的进展[J].福建医药杂志,2017,39(6):9-13.
[4]陈庞何,成俊芬.雷公藤多苷治疗炎症性疾病的研究进展[J].世界最新医学信息文摘,2017,17(72):13-14.
[5]邹顺,班立丽,冯莉嵋,等.复方α-酮酸片治疗2型糖尿病合并早期糖尿病肾病的临床观察[J].中国药房,2017,28(35):4981-4983.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南:2010年版[J].中国实用乡村医生杂志,2012,17(6):1-9.
[7]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:263-264.
[8]孙迎春,解汝娟.糖尿病肾病发病机制的研究进展[J].医学综述,2017,23(16):3286-3290.
[9]朱俊.细胞因子在糖尿病肾病发生、发展过程中的作用[J].河北医药,2017,39(15):2369-2371.
[10]蒯巧林.雷公藤多苷治疗糖尿病肾病的效果和安全性[J].中外医学研究,2017,15(26):10-11.
[11]张敏,王璐.复方α酮酸辅助治疗对早期糖尿病肾病患者血清肾功能指标以及营养状态的影响[J].海南医学院学报,2016,22(21):2558-2561.
[12]刘凌汐,于洋.雷公藤多苷片联合复方α-酮酸片治疗糖尿病肾病的临床观察[J].中国药房,2017,28(33):4654-4657.
[13]陈卫东.肾炎康复联合雷公藤多苷对早期糖尿病肾病炎性因子及肾功能的影响[J].实用糖尿病杂志,2017,13(5):45-46.
[14]费沛,张庆红,胡兆雄.雷公藤多苷联合酮酸低蛋白饮食对老年糖尿病肾病患者肾功能的影响[J].现代中西医结合杂志,2016,25(17):1882-1884.
[15]廖涛生,冯涛,刘炳贤,等.肾小球滤过率与血清VEGF、胆红素水平在糖尿病肾病中的关系研究[J].标记免疫分析与临床,2017,24(11):1263-1268.
[16]何凌志,龙峥嵘. Cys-C、hs-CRP和Hcy联合检测对糖尿病肾病的早期诊断价值[J].吉林医学,2017,38(12):2335-2337.
[17]热孜万古丽·阿布都拉,宋雪.厄贝沙坦联合阿托伐他汀治疗对早期糖尿病肾病患者血清Cys C、Hcy、TNF-α、ET、TGF-b1水平的影响[J].海南医学院学报,2017,23(20):2776-2782.
[18]姚玉红,郭莉阁.糖肾宁对气阴两虚夹瘀型早期糖尿病肾病患者HGF,CysC和TGF-β1水平的影响[J].中国实验方剂学杂志,2015,21(12):139-142.
[19]翟海峰.雷公藤提取物联合α酮酸对糖尿病肾病患者血清同型半胱氨酸及血管内皮生长因子水平的影响[J].中国医药科学,2017,7(16):44-47.