糖肾康颗粒对糖尿病肾病气阴两虚、瘀血阻络证患者血清胱抑素C及尿纤维连接蛋白的干预作用

Effects of Tangshenkang Granule on Serum Cystatin C and Urinary Fibronectin in Diabetic Nephropathy Patients with Dual Deficiency of Qi and Yin and Blood Stasis Blocking Collaterals

目的 观察Ⅲ～Ⅳ期糖尿病肾病（diabetic nephropathy,DN）气阴两虚、瘀血阻络证患者血清胱抑素C（cystatin C,CysC）、尿纤维连接蛋白（urinary fibronectin,UFn）水平及糖肾康颗粒的干预作用.方法 将60例Ⅲ～Ⅳ期糖尿病肾病气阴两虚、瘀血阻络证患者随机分为治疗组和对照组,各30例,并选取20名健康体检者作为正常组.治疗组与对照组均给予常规降糖、降压治疗,治疗组加用糖肾康颗粒,疗程2个月.治疗前后分别检测治疗组与对照组尿白蛋白/尿肌酐比值（microalbuminuria/urine creatinine,MAU/UCr）、肾小球滤过率估算值（estimated glomerular filtration rate,eGFR）以及CysC、UFn水平,并与正常组比较.结果 治疗组中医证候疗效显著优于对照组（P＜0.01）;在降低MAU/UCr比值和CysC、UFn水平,以及升高eGFR水平方面,治疗组显著优于对照组（P＜0.01）.结论 糖肾康颗粒可降低Ⅲ～Ⅳ期DN气阴两虚、瘀血阻络证患者血清CysC、UFn水平,并可减少DN患者尿蛋白排泄,维持肾小球滤过率,在一定程度上具有保护肾功能、延缓疾病进展的作用.

Objective To observe the effects of Tangshenkang Granule on serum cystatin C （CysC） and u- rinary fibronectin （UFn） in stage III-IV diabetic nephropathy （DN） patients with dual deficiency of qi and yin and blood stasis blocking collaterals. Methods Sixty stage III-IV DN patients with dual deficiency of qi and yin and blood stasis blocking collaterals were randomly divided into treatment group （n=30） and control group （n = 30）; 20 healthy persons who underwent physical examination were selected as normal group. The treatment group and control group received conventional antidiabetic and antihypertensive treatment; additionally, the treatment group was given Tangshenkang Granule. The course of treatment was 2 months in the two groups. Before and after treatment, microalbuminuria/urine creatinine （MAU/UCr）, estimated glomerular filtration rate （eGFR）, and CysC and UFn levels were determined and compared between the three groups. Results The treatment group had significantly more improvements in traditional Chinese medicine syndromes than the control group （P〈0.01）. Compared with the control group, the treatment group had significantly higher decreases in MAU/UCr and CysC and UFn levels and a significantly higher increase in eGFR （P〈0.01）. Conclusion Tangshenkang Granule can decrease serum CysC and UFn levels, reduce urinary protein excretion, and maintain GFR in stage III-IV DN patients with dual deficiency of qi and yin and blood stasis blocking collaterals, thus protecting renal function and delaying disease progression.