摘要
目的探讨益气养阴通络汤联合贝那普利治疗糖尿病肾病(diabetic nephropathy,DN)的疗效及对转化生长因子-β_(1)(transforming growth factor-β_(1),TGF-β_(1)),血管内皮生长因子(vascular endothelial growth factor,VEGF)影响。方法选取2019年10月—2021年10月医院收治的DN病人94例,随机分为对照组(n=48)和观察组(n=46)。入院后两组病人均实施生活方式相关的指导,包括体质量控制、运动、戒烟酒等,给予脂质的代谢紊乱相关纠正、血糖控制、血压等基础的治疗,对照组实施盐酸贝那普利片的口服治疗,观察组则在此基础上实施益气养阴通络汤治疗,两组持续治疗4周。对比两组临床疗效、尿微量白蛋白(microalbumin,mALB)、尿白蛋白肌酐比(urine albumin creatine ratio,UACR)、β_(2)微球蛋白(β_(2)-microglobulin,β_(2)-MG)水平、中医证候评分、血清同型半胱氨酸(homocysteine,Hcy)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、血清TGF-β_(1)和VEGF及空腹血糖(fasting plasma glucose/fasting blood glucose,FPG)、餐后2 h血糖(2 hour postprandial blood glucose,2 h PG)和糖化血红蛋白(glyeosylated hemoglobin,HbAlc)指标变化。结果治疗前两组mALB、UACR、β_(2)-MG指标间无统计学意义(P>0.05);治疗后两组mALB、UACR、β_(2)-MG指标较治疗前显著降低(P<0.05);并且观察组降低较明显(P<0.05);观察组治疗总有效率较对照组明显较高(P<0.05);治疗后两组主症评分、次症评分和中医证候总评分明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组血清Hcy、TNF-α、IL-6指标明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组血清TGF-β_(1)和VEGF指标较治疗前明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组FPG、2 h PG和HbAlc指标较治疗前明显降低(P<0.05);且观察组降低较明显(P<0.05)。结论采用益气养阴通络汤联合贝那普利治疗DN具有较好的临床疗效,可降低血清TGF-β_(1),VEGF指标,降低蛋白尿水平。
Objective To investigate the efficacy of Yiqi Yangyin Tongluo Decoction(益气养阴通络汤)combined with benazepril in the treatment of diabetic nephropathy(DN)and the effects on serum transforming growth factor-β_(1)(TGF-β_(1))and vascular endothelial growth factor(VEGF).Methods A total of 94 DN invalids admitted to the hospital from October 2019 to October 2021 were selected and randomly divided into control group(48 cases)and observation group(46 cases).After admission,the invalids in two groups were given lifestyle guidance,including exercise,weight control,smoking cessation,alcohol,etc.,and basic treatments such as correcting lipid metabolism disorders,controlling blood glucose and blood pressure.The control group was given benazepil hydrochloride tablets orally,and the observation group was given Yiqi Yangyin Tongluo Decoction on the basis of the control group.The clinical efficacy,microalbumin(mALB),urine albumin creatine ratio(UACR),β_(2)-microglobulin(β_(2)-MG),TCM syndrome scores,serum homocysteine(Hcy),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum TGF-β_(1) and VEGF,fasting plasma glucose/fasting blood glucose(FPG),2 hour postprandial blood glucose(2 h PG)and glyeosylated hemoglobin(HbAlc)were compared between two groups.Results Before treatment,there was no difference in mALB,UACR orβ_(2)-MG indicators between two groups(P>0.05).After treatment,the indicators of mALB,UACR andβ_(2)-Mg in two groups were obvious decreased compared with those before treatment(P<0.05).And those of the observation group decreased obviously(P<0.05).The total effective rate in the observation group was obvious higher than that in the control group(P<0.05).After treatment,the scores of primary symptoms,secondary symptoms and TCM syndrome were obvious decreased in two groups(P<0.05).And those of the observation group decreased obviously(P<0.05).After treatment,the indicators of serum Hcy,TNF-αand IL-6 in two groups were obvious decreased(P<0.05).And those of the observation group decreased obviously(P<0.05).After treatment,the levels of serum TGF-β_(1) and VEGF in both groups were obvious lower than those before treatment(P<0.05).And those of the observation group decreased obviously(P<0.05).After treatment,the levels of FPG,2 h PG and HbAlc in two groups were obviously lower than those before treatment(P<0.05).And those of the observation group decreased obviously(P<0.05).Conclusion The combination of Yiqi Yangyin Tongluo Decoction and benazepril in the treatment of DN has a good clinical effect,and it can reduce the levels of TGF-β_(1),VEGF and proteinuria.
作者
陈仕银
胡朋
CHEN Shiyin;HU Peng(Department of Traditional Chinese Medicine,Haikou People's Hospital,Haikou 570000,Hainan,China)
出处
《中华中医药学刊》
CAS
北大核心
2024年第3期238-242,共5页
Chinese Archives of Traditional Chinese Medicine
基金
海南省自然科学基金项目(820MS162)。
