百令胶囊联合厄贝沙坦对糖尿病肾病患者氧化应激、炎症反应及免疫功能的影响
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摘要
目的:探究百令胶囊联合厄贝沙坦对糖尿病肾病患者氧化应激、炎症反应及免疫功能的影响。方法:选择我院收治的142例糖尿病肾病患者作为研究对象,随机分为对照组71例及观察组71例。对两组糖尿病肾病患者肾功能、氧化应激、炎症及免疫指标进行比较分析。结果:治疗后,两组糖尿病肾病(DN)患者尿素氮(BUN)、肌酐(SCr)、尿白蛋白排泄率(UARE)、血清活性氧(ROS)、晚期蛋白氧化产物(AOPPS)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、CD8~+均较治疗前显著下降(P<0.05),而超氧化物歧化酶(SOD)、CD4~+、CD4~+/CD8~+较治疗前明显上升(P<0.05);且治疗后观察组BUN、SCr、UARE、ROS、AOPPS、TNF-α、CRP、CD8~+显著低于对照组(P<0.05),而SOD、CD4~+、CD4~+/CD8~+显著高于对照组(P<0.05)。结论:百令胶囊联合厄贝沙坦治疗DN,可有效改善患者的肾功能,氧化炎症反应,及增强患者的免疫功能,具有临床推广意义。
Objective: To explore the effects of Bailing capsule combined with irbesartan on oxidative stress, inflammatory response and immune function in patients with diabetic nephropathy. Methods 142 patients with diabetic nephropathy admitted to our hospital from April 2017 to July 2018 were selected as the study subjects. 71 cases in the control group and 71 cases in the observation group were randomly assigned. The renal function, oxidative stress, inflammation and immune indexes of two groups of patients with diabetic nephropathy were compared and analyzed. Results After treatment, the levels of BUN, SCr, UARE, ROS, AOPPS, TNF-a, CRP and CD8~+ of DN patients in both groups decreased significantly compared with those before treatment(P<0.05), while the levels of SOD, CD4~+, CD4~+/CD8~+ increased significantly compared with those before treatment(P<0.05); and the levels of BUN, SCr, UARE, ROS, AOPPS, TNF-a, CRP and CD8~+ in the observation group were significantly lower than those in the control group(P<0.05), while the levels of SOD, CD4~+, CD4~+/CD8~+ in the observation group were significantly higher than those in the control group(P<0.05). Conclusions Bailing capsule combined with irbesartan in the treatment of DN can effectively improve the renal function, oxidize inflammatory reaction and enhance the immune function of patients, which has clinical significance.
Objective: To explore the effects of Bailing capsule combined with irbesartan on oxidative stress, inflammatory response and immune function in patients with diabetic nephropathy. Methods 142 patients with diabetic nephropathy admitted to our hospital from April 2017 to July 2018 were selected as the study subjects. 71 cases in the control group and 71 cases in the observation group were randomly assigned. The renal function, oxidative stress, inflammation and immune indexes of two groups of patients with diabetic nephropathy were compared and analyzed. Results After treatment, the levels of BUN, SCr, UARE, ROS, AOPPS, TNF-a, CRP and CD8~+ of DN patients in both groups decreased significantly compared with those before treatment(P<0.05), while the levels of SOD, CD4~+, CD4~+/CD8~+ increased significantly compared with those before treatment(P<0.05); and the levels of BUN, SCr, UARE, ROS, AOPPS, TNF-a, CRP and CD8~+ in the observation group were significantly lower than those in the control group(P<0.05), while the levels of SOD, CD4~+, CD4~+/CD8~+ in the observation group were significantly higher than those in the control group(P<0.05). Conclusions Bailing capsule combined with irbesartan in the treatment of DN can effectively improve the renal function, oxidize inflammatory reaction and enhance the immune function of patients, which has clinical significance.
引文
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9 陈娣,吴甫民.百令胶囊辅助治疗原发性肾病综合征疗效及对细胞免疫功能 、微炎症状态的影响[J].陕西中医,2017,38(12):1670-1672.
10 黄龙,吴杰,廖婷婷.前列地尔联合百令胶囊治疗慢性肾衰竭疗效观察[J].中国药师,2014,17(7):1162-1164.
11 Tagawa A,Yasuda M,Kume S,et al.Impaired podocyte autophagy exacerbates proteinuria in diabetic nephropathy[J].Diabetes,2016,65(3):755-767.
12 Gnudi L,Coward RJM,Long DA.Diabetic nephropathy:perspective on novel molecular mechanisms[J].Trends Endocrinol Metab,2016,27(11):820-830.
13 Chan GC,Tang SC.Diabetic nephropathy:landmark clinical trials and tribulations[J].Nephrol Dial Transplant,2016,31(3):359-368.
14 Yu L,Hanwei H,Wenjuan Z,et al.Effect of irbesartan on the expression of osteocalcin in renal tissue of type 2 diabetic rats[J].Clin Med,2017,14(9):1060-1064.
15 Chen YY,Liu P,Chen X,et al.Effects of different doses of irbesartan combined with spironolactone on urinary albumin excretion rate in elderly patients with early type 2 diabetic nephropathy[J].Am J Med Sci,2018,355(5):418-424.
16 郭利莎,沈玉燕,赵玲,等.当代名中医临床辨治糖尿病肾病规律探讨[J].中国中医基础医学杂志,2015,21(4):427-428,439.
17 刘冰洋,邹欣蓉,刘琼,等.中药治疗糖尿病肾病的研究进展[J].中国中西医结合杂志,2016,36(12):1527-1530.
18 Miranda-Díaz AG,Pazarín-Villaseňor L,Yanowsky-Escatell FG,et al.Oxidative stress in diabetic nephropathy with early chronic kidney disease[J].J Diabetes Res,2016,2016:7047238.
19 Sauriasari R,Andrajati R,Azizahwati,et al.Marker of lipid peroxidation related to diabetic nephropathy in Indonesian type 2 diabetes mellitus patients[J].Diabetes Res Clin Pract,2015,108(1):193-200.
20 Miljkovic M,Koturstevuljevic J,Stefanovic A,et al.Advanced oxidation protein products (AOPPs) in lipoprotein subfractions in patients with different stages of renal disease[J].Atherosclerosis,2017,263:e190.
21 董嘉德,黄昌靖.人工虫草制剂对支原体肺炎患儿血清降钙素原、CRP及IL-17水平的影响[J].中国生化药物杂志,2016,36(3):99-101.
22 Wada J,Makino H.Innate immunity in diabetes and diabetic nephropathy[J].Nat Rev Nephrol,2016,12(1):13-26.
23 郭洁.那曲冬虫夏草菌株的分离、发酵及虫草多糖免疫功能评价[D].河北农业大学,2015.
2 Bramham K.Diabetic nephropathy and pregnancy[J].Semin Nephrol,2017,37(4):362-369.
3 Seki N,Matsumoto T,Fukazawa M.Relationship between the brain natriuretic peptide (BNP) level and prognosis of diabetic nephropathy with microalbuminuria:A 7-year follow-up study[J].Horm Metab Res,2018,50(5):389-396.
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 祝亮.厄贝沙坦对早期糖尿病肾病患者血脂及肾功能的影响[J].中国药业,2015,24(11):10-11.
6 Wang CY,Min CY,Rong XL,et al.Irbesartan can improve blood lipid and the kidney function of diabetic nephropathy[J].Discov Med,2015,20(108):67-77.
7 江旭锋,曾庆春,黄岑汉,等.糖尿病肾病中医病因病机探要[J].河南中医,2016,36(5):924-926.
8 朱宜临,钱秋海,张新颖.糖尿病肾病中西医研究进展[J].山东中医杂志,2017,36(1):82-84,88.
9 陈娣,吴甫民.百令胶囊辅助治疗原发性肾病综合征疗效及对细胞免疫功能 、微炎症状态的影响[J].陕西中医,2017,38(12):1670-1672.
10 黄龙,吴杰,廖婷婷.前列地尔联合百令胶囊治疗慢性肾衰竭疗效观察[J].中国药师,2014,17(7):1162-1164.
11 Tagawa A,Yasuda M,Kume S,et al.Impaired podocyte autophagy exacerbates proteinuria in diabetic nephropathy[J].Diabetes,2016,65(3):755-767.
12 Gnudi L,Coward RJM,Long DA.Diabetic nephropathy:perspective on novel molecular mechanisms[J].Trends Endocrinol Metab,2016,27(11):820-830.
13 Chan GC,Tang SC.Diabetic nephropathy:landmark clinical trials and tribulations[J].Nephrol Dial Transplant,2016,31(3):359-368.
14 Yu L,Hanwei H,Wenjuan Z,et al.Effect of irbesartan on the expression of osteocalcin in renal tissue of type 2 diabetic rats[J].Clin Med,2017,14(9):1060-1064.
15 Chen YY,Liu P,Chen X,et al.Effects of different doses of irbesartan combined with spironolactone on urinary albumin excretion rate in elderly patients with early type 2 diabetic nephropathy[J].Am J Med Sci,2018,355(5):418-424.
16 郭利莎,沈玉燕,赵玲,等.当代名中医临床辨治糖尿病肾病规律探讨[J].中国中医基础医学杂志,2015,21(4):427-428,439.
17 刘冰洋,邹欣蓉,刘琼,等.中药治疗糖尿病肾病的研究进展[J].中国中西医结合杂志,2016,36(12):1527-1530.
18 Miranda-Díaz AG,Pazarín-Villaseňor L,Yanowsky-Escatell FG,et al.Oxidative stress in diabetic nephropathy with early chronic kidney disease[J].J Diabetes Res,2016,2016:7047238.
19 Sauriasari R,Andrajati R,Azizahwati,et al.Marker of lipid peroxidation related to diabetic nephropathy in Indonesian type 2 diabetes mellitus patients[J].Diabetes Res Clin Pract,2015,108(1):193-200.
20 Miljkovic M,Koturstevuljevic J,Stefanovic A,et al.Advanced oxidation protein products (AOPPs) in lipoprotein subfractions in patients with different stages of renal disease[J].Atherosclerosis,2017,263:e190.
21 董嘉德,黄昌靖.人工虫草制剂对支原体肺炎患儿血清降钙素原、CRP及IL-17水平的影响[J].中国生化药物杂志,2016,36(3):99-101.
22 Wada J,Makino H.Innate immunity in diabetes and diabetic nephropathy[J].Nat Rev Nephrol,2016,12(1):13-26.
23 郭洁.那曲冬虫夏草菌株的分离、发酵及虫草多糖免疫功能评价[D].河北农业大学,2015.