糖肾宁对早期糖尿病肾病细胞因子的影响研究

Effect of Traditional Chinese Medicine Tangshenning on cytokines in patients with early diabetic nephropathy

目的:探讨糖肾宁对早期糖尿病肾病(DN)细胞因子的影响。方法:对78例早期DN(Ⅲ期)患者采用中心分层、区组随机化方法分为治疗组(糖肾宁组)与对照组(西药常规组)。对照组38例患者采用替米沙坦80mg,1次/d进行治疗。治疗组在对照组基础上每天加服中药糖肾宁1剂,分2次口服,8周为一疗程。采用双抗体夹心酶联免疫法(ELISA法)检测78例早期DN患者治疗前、治疗4周、治疗8周后血清和尿液中白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)及转化生长因子-β1(TGF-β1)水平的变化。结果:两组治疗前血、尿IL-6、TNF-a、TGF-β1水平明显高于健康组(P<0.01);随着治疗时间的延长两组血、尿中上述细胞因子水平逐步下降,但治疗组在治疗4周和8周后均下降明显(P<0.01);对照组4周时无明显变化;8周后也下降(P<0.05)。对照组TGF-β1治疗4周、8周均无明显变化;治疗组与对照组同期血、尿中IL-6、TNF-α、TGF-β1水平比较,差异有统计学意义(P<0.01)。结论:细胞因子与DN的发病、发展有密切关系,糖肾宁对血、尿中IL-6、TNF-α、TGF-β1有明显的下调作用。

Objective： To discuss the effects of Tangshenning on cytokines in patients with early diabetic nephropathy. Methods： 78 early diabetic nephropathy eases （stage Ⅲ ） were divided into treatment group and control group according to blocked randomization method. 38 cases of the control group were treated by telmisartan, 80 mg, qd, the treatment group was given the same dosage of telmisartan and an additional dose of Tangshenning per day （oral, bid）. One course was consisted of eight days. At three time points including 4 weeks before the treatment, the week when the treatment started, and 8 weeks after the treatment, IL-6,TNF-αand TGF-β1 in serum and urine in all cases were evaluated and compared u-sing enzyme-linked immunosorbent assay （ELISA）. Results. Before treatment, IL-6,TNF-αand TGF-β1 of the two groups were obvious higher than that of normal levels （P〈0.01）. After the treatment, cytokines of both treatment group and the control group showed descent tendency. After 4 weeks and 8 weeks of treatment, cytokines in treatment group significantly decreased （P all 〈0. 01）, while for the control group, the decrease become significant only after 8 weeks of treatment. TGF-β1 level of the control group almost remained the same after 8 weeks of treatment. There was significant difference between the levels of IL-6, TNF-αand TGF-β1 in both serum and urine between the two groups （P〈0.01）. Conclusions： Cy- tokines is correlated to the development of diabetic nephropathy, and Tangshenning can obviously lower IL-6,TNF-α and TGF-β1 in serum and urine for early diabetic nephropathy patients.