滋阴清热法对早期糖尿病肾病患者血脂及血清晚期糖基化终末产物水平的影响

Effect of Nourishing Yin and Clearing Heat therapy on blood lipid and serum advanced glycation end products in early diabetic nephropathy

目的观察滋阴清热法配合西医治疗对早期糖尿病肾病患者血脂及血清晚期糖基化终末产物(AGEs)水平的影响。方法将2012年6月至2013年12月我院治疗的38例早期糖尿病肾病患者在西医常规治疗的基础上给予自拟的滋阴清热方,每日1剂,早晚分次服用。分别在治疗前,治疗第4、8、12周末测定空腹血糖(FBG)、血肌酐(SCr)、尿微量白蛋白排泄率(UAER),并在治疗前、后测定血甘油三酯(TG)、总胆固醇(TC)及AGEs,应用方差分析比较各指标的变化情况。结果经过治疗后,FBG在治疗前后比较差异均无统计学意义(P>0.05);UAER在治疗第8周后,与治疗前比较差异有统计学意义(P<0.01);SCr在治疗第4周后,与治疗前比较差异有统计学意义(P<0.05);经过治疗后患者TG、TC、AGEs水平均较治疗前明显下降(P<0.01)。结论滋阴清热方配合西医治疗不仅能调节血脂,还能明显降低早期糖尿病肾病患者血浆AGEs水平,这可能是其保护糖尿病肾病患者的机制之一。

Objective To determine the effects of Nourishing Yin and Clearing Heat therapy in conjunction with western medicine on blood lipid and advanced glycation end products （AGEs） in early diabetic nephropathy. Methods Between June 2012 and December 2013, we recruited 38 patients with early diabetic nephropathy who were treated with the Nourishing Yin and Clearing Heat liquid decoction plus western medicine once daily. This en-tailed the measurement of fasting blood-glucose （FBG）, serum creatinine （SCr）, urinary albumin excretion rate （UAER）, serum triglyceride （TG）, total cholesterol （TC） and AGEs before the therapy and at weeks 4, 8 and 12, respectively. SPSS 17.0 software package was employed to conduct statistical analyses. Results The difference in FBG was unre-markable before and after treatment （P〉0.05）. Compared with pre-treatment levels, the difference in UAER was statis-tically significant at week 8 （P〈0.05）, but not at week 4. There was a marked difference in SCr at week 4 compared with pre-treatment level （P〈0.05）. The reduction in TC, TG and AGEs was remarkable after treatment （all P〈0.01）. Conclusion The Nourishing Yin and Clearing Heat decoction effectively reduces blood lipids and serum AGEs, which is putatively the mechanism responsible for alleviating the renal injury in patients with diabetic nephropathy.