健脾补肾化瘀泻浊法配合西药治疗早期糖尿病肾病疗效及对血浆生长分化因子-15、血管内皮生长因子和内皮抑素水平的影响
|
摘要
目的探讨健脾补肾化瘀泻浊法配合西药治疗早期糖尿病肾病疗效及对血浆生长分化因子-15(GDF-15)、血管内皮生长因子(VEGF)和内皮抑素(ES)水平的影响。方法将100例早期糖尿病肾病患者随机分为2组,对照组50例给予盐酸贝那普利治疗,观察组50例给予盐酸贝那普利联合健脾补肾化瘀泻浊法治疗,观察2组治疗前后血脂、肾功能相关指标及血浆GDF-15、VEGF和ES水平变化情况,统计2组疗效及不良反应发生情况。结果 2组治疗后TG、TC、LDL-C、β_2微球蛋白、尿微量白蛋白、尿蛋白肌酐比值及血浆GDF-15、VEGF和ES水平均明显低于治疗前(P均<0.05),且观察组明显低于对照组(P均<0.05);2组治疗后HDL-C水平均明显升高(P均<0.05),且观察组明显高于对照组(P<0.05);观察组治疗后总有效率显著高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论健脾补肾化瘀泻浊法配合西药治疗早期糖尿病肾病疗效较佳,且可显著降低血浆GDF-15、VEGF和ES水平。
Objective It is to investigate the therapeutic effect of therapy for tonifying spleen and kidney, removing phlegm and blood stasis combined with western medicine on early diabetic nephropathy and its effect on the levels of plasma growth differentiation factor-15(GDF-15), vascular endothelial growth factor(VEGF) and endostatin(ES). Methods 100 patients with early diabetic nephropathy were randomly divided into 2 groups. 50 patients in the control group were treated with benazepril hydrochloride. 50 patients in the observation group were treated with benazepril hydrochloride combined with Chinese medicine for tonifying spleen and kidney, removing phlegm and blood stasis. The changes of blood lipids, blood glucose, renal function and plasma GDF-15, VEGF and ES levels before and after treatment were analyzed. The efficacy and adverse reactions of the two groups were statistically analyzed. Results The levels of TG, TC, LDL-C, β_2 microglobulin, urinary microalbumin, urinary albumin creatinine ratio, and the levels of plasma GDF-15, VEGF, and ES after treatment were lower than those before treatment in the two groups(P<0.05), and the indexes in the observation group were lower than those in the control group(P<0.05); the HDL-C level was increased after treatment in the two groups(P<0.05), and the level in the observation group was higher than that in the control group(P<0.05). The effective rate in the observation group was significantly higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Jianpi Bushen Huayu Xiezhuo method combined with western medicine is effective in the treatment of early diabetic nephropathy, and can significantly reduce the levels of plasma GDF-15, VEGF and ES.
Objective It is to investigate the therapeutic effect of therapy for tonifying spleen and kidney, removing phlegm and blood stasis combined with western medicine on early diabetic nephropathy and its effect on the levels of plasma growth differentiation factor-15(GDF-15), vascular endothelial growth factor(VEGF) and endostatin(ES). Methods 100 patients with early diabetic nephropathy were randomly divided into 2 groups. 50 patients in the control group were treated with benazepril hydrochloride. 50 patients in the observation group were treated with benazepril hydrochloride combined with Chinese medicine for tonifying spleen and kidney, removing phlegm and blood stasis. The changes of blood lipids, blood glucose, renal function and plasma GDF-15, VEGF and ES levels before and after treatment were analyzed. The efficacy and adverse reactions of the two groups were statistically analyzed. Results The levels of TG, TC, LDL-C, β_2 microglobulin, urinary microalbumin, urinary albumin creatinine ratio, and the levels of plasma GDF-15, VEGF, and ES after treatment were lower than those before treatment in the two groups(P<0.05), and the indexes in the observation group were lower than those in the control group(P<0.05); the HDL-C level was increased after treatment in the two groups(P<0.05), and the level in the observation group was higher than that in the control group(P<0.05). The effective rate in the observation group was significantly higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Jianpi Bushen Huayu Xiezhuo method combined with western medicine is effective in the treatment of early diabetic nephropathy, and can significantly reduce the levels of plasma GDF-15, VEGF and ES.
引文
[1] 杨雁,余学锋.糖尿病肾病机制的研究进展[J].临床肾脏病杂志,2012,12(5):196-198
[2] 李秋英,刘静云,朱红爱,等.中医药治疗糖尿病肾病进展[J].河北中医,2008,30(6):656-658
[3] 辰琦,孙伟.中医药治疗糖尿病肾病进展[J].河南中医,2013,33(6):992-993
[4] 姚乃礼.中医证候鉴别诊断学[M].2版.北京:人民卫生出版社,2002:51-54
[5] 中华医学会糖尿病学分会微血管并发症学组.糖尿病皆病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792-801
[6] 国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:134-135
[7] 陈航,肖文选,李会英,等.糖尿病肾病进展的危险因素[J].中国综合临床,2000,16(8):597
[8] Mugica F,Nebot A,Bagherpour S.A model for continuous monitoring of patients with major depression in short and long term periods[J].Technol Health Care,2016,14(9):65-71
[9] 吴一鸣,杨震,秦利,等.糖尿病肾病的表观遗传学机制[J].国际内分泌代谢杂志,2017,37(1):48-51
[10] 岳原.西医治疗糖尿病肾病的研究进展[J].中国优生优育,2014,20(4):269-270
[11] 金莹,童林萍,沈培红,等.糖尿病肾病进展机制及血糖波动、氧化应激状况的研究[J].中国基层医药,2017,24(13):1954-1958
[12] 许倬,涂晓文,曹海丽.糖尿病肾病治疗临床试验的研究进展[J].中国全科医学,2017,11(20):2535-2538
[13] 程蓓蓓,徐云生.中医疗法治疗细胞因子介导的糖尿病肾病进展[J].河北中医,2016,38(6):957-960
[14] 俞翔,陈敏.中西医结合治疗糖尿病肾病疗效观察[J].现代中西医结合杂志,2012,21(28):3107-3108
[15] 左军,张文钊,胡晓阳,等.黄芪现代药理及临床研究进展[J].中医药信息,2014,31(1):111-112
[16] 张敏,高晓红,孙晓萌,等.茯苓的药理作用及研究进展[J].北华大学学报:自然科学版,2008,9(1):63-68
[17] 禹建春,叶红梅,林西西,等.泽泻的药理研究概况[J].海峡药学,2011,23(2):92-93
[2] 李秋英,刘静云,朱红爱,等.中医药治疗糖尿病肾病进展[J].河北中医,2008,30(6):656-658
[3] 辰琦,孙伟.中医药治疗糖尿病肾病进展[J].河南中医,2013,33(6):992-993
[4] 姚乃礼.中医证候鉴别诊断学[M].2版.北京:人民卫生出版社,2002:51-54
[5] 中华医学会糖尿病学分会微血管并发症学组.糖尿病皆病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792-801
[6] 国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:134-135
[7] 陈航,肖文选,李会英,等.糖尿病肾病进展的危险因素[J].中国综合临床,2000,16(8):597
[8] Mugica F,Nebot A,Bagherpour S.A model for continuous monitoring of patients with major depression in short and long term periods[J].Technol Health Care,2016,14(9):65-71
[9] 吴一鸣,杨震,秦利,等.糖尿病肾病的表观遗传学机制[J].国际内分泌代谢杂志,2017,37(1):48-51
[10] 岳原.西医治疗糖尿病肾病的研究进展[J].中国优生优育,2014,20(4):269-270
[11] 金莹,童林萍,沈培红,等.糖尿病肾病进展机制及血糖波动、氧化应激状况的研究[J].中国基层医药,2017,24(13):1954-1958
[12] 许倬,涂晓文,曹海丽.糖尿病肾病治疗临床试验的研究进展[J].中国全科医学,2017,11(20):2535-2538
[13] 程蓓蓓,徐云生.中医疗法治疗细胞因子介导的糖尿病肾病进展[J].河北中医,2016,38(6):957-960
[14] 俞翔,陈敏.中西医结合治疗糖尿病肾病疗效观察[J].现代中西医结合杂志,2012,21(28):3107-3108
[15] 左军,张文钊,胡晓阳,等.黄芪现代药理及临床研究进展[J].中医药信息,2014,31(1):111-112
[16] 张敏,高晓红,孙晓萌,等.茯苓的药理作用及研究进展[J].北华大学学报:自然科学版,2008,9(1):63-68
[17] 禹建春,叶红梅,林西西,等.泽泻的药理研究概况[J].海峡药学,2011,23(2):92-93