糖肾化浊方对IV期糖尿病肾病患者血清转化生长因子-β1和血小板源生长因子浓度的影响

Effect ofTangshen-Huazhuorecipe on the levels of serum transforming growth factorβ1 and platelet derived growth factor in patients with IV stage of diabetic nephropathy

目的：探讨糖肾化浊方对IV期糖尿病肾病（diabetic nephropathy，DN）患者血清转化生长因子-β1（TGF-β1）和血小板源生长因子（PDGF）浓度的影响。方法收集2012年6-12月在首都医科大学附属北京同仁医院就诊的IV期DN患者98例，采用随机数字表法将患者分为治疗组（48例）和对照组（50例），均采用常规降糖、降压、调脂和抗凝治疗，停服血管紧张素转化酶抑制药或其他血管紧张素 II受体拮抗药。对照组在此基础上口服厄贝沙坦，150 mg/d。治疗组在对照组治疗基础上加服糖肾化浊方。两组治疗后6个月检测血清TGF-β1和PDGF浓度，并观察尿微量白蛋白排泄率（UAER）、血尿素氮（BUN）、血肌酐（Scr）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）的变化。结果治疗后，治疗组TGF-β1、PDGF水平[（123.6±21.2）pg/ml、（500.6±130.2）pg/ml]较同组治疗前[（172.5±31.3）pg/ml、（860.9±131.2）pg/ml]明显下降（P＜0.01），且与对照组治疗后[（157.4±39.6）pg/ml、（765.7±161.8）pg/ml]比较，差异有统计学意义（P＜0.01）。治疗后治疗组TG、TC、HDL-C、LDL-C、UAER[（1.72±0.25）mmol/L、（4.56±0.64）mmol/L、（1.56±0.50）mmol/L、（2.46±1.08）mmol/L、（100.73±204.24）μg/min]均优于对照组[（2.09±0.27）mmol/L、（6.11±0.93）mmol/L、（1.36±0.44）mmol/L、（3.32±0.87）mmol/L、（226.24±396.38）μg/min，P＜0.05或0.01]。结论糖肾化浊方可降低IV期DN患者血清TGF-β、PDGF浓度，抑制或改善肾小球硬化发生、发展过程。

Objective To investigate the effect of extract ofTangshen-HuazhuoRecipe（TSHZR） on the serum concentrations of transforming growth factorβ1（TGF-β1） and platelet derived growth factor（PDGF） in patients withⅣ stage of diabetic nephropathy（DN）.Methods From June 2012 to December 2012, 98 patients ofⅣstage DN in our hospital outpatient were enrolled and randomly divided into treatment group（n=48） and control group（n=50） using random number table. All patients received conventional therapies of controlling blood sugar, lipid, blood pressure and anticoagulant therapy. On such basis, the control group was treated by irbesartan, 150 mg/d, and the treated group treated by TSHZR combined with irbesartan,150 mg/d, for 6 months. Serum TGF-β1 and PDGF were determined with ELISA before and after treatment,and urinary albumin excretion rate,HbA1c,serum creatinine,blood urea nitrogen and lipid profiles were examined as well. ResultsIn the treated group, the TGF-β1 was（172.5±31.3）, （123.6±21.2）pg/ml, the PDGF was（860.9± 131.2）, （500.6±130.2）pg/ml before the treatment and after the treatment, respectively. The TGF-β1 and PDGF after the treatment were significantly decreased than those before the treatment（P〈0.01）. After the treatment, TGF-β1 and PDGF in the treated group were statistically significant compared to the control group[TGF-β1 is（157.4±39.6）pg/ml, PDGF is（765.7±161.8）]pg/ml,P〈0.01）. After the treatment, the treatment group was superior to the control group in TG（1.72±0.25）mmol/L,（2.09±0.27）mmol/L,（P〈0.01）, TC（4.56± 0.64）mmol/L,（6.11±0.93）mmol/L, （P〈0.01）, HDL-C（1.56±0.50）mmol/L,（1.36±0.44）mmol/L, （P〈0.01）, LDL-C（2.46±1.08）mmol/L（3.32±0.87）mmol/L,（P〈0.05）and UAER（100.73±204.24）μg/min, （226.24±396.38）μg/min, （P〈0.01）.Conclusion TSHZR can inhibit the progressive of IV stage of diabetic nephropathy by suppressing TGF-β1 and PDGF expression level.