糖肾康颗粒对糖尿病肾病气阴两虚证患者血清C反应蛋白、白介素6和白介素18的影响

Effect of Tangshenkang Granules on Serum C Reactive Protein,interleukin 6 and 18 of DN Patients with Syndrome of Deficient Qi and Yin

目的观察糖肾康颗粒对糖尿病肾病(DN)气阴两虚证患者的临床疗效,探讨其可能的作用机制。方法 60例DN气阴两虚证患者随机分为治疗组和对照组各30例,另选取20名健康体检者作为正常组。治疗组与对照组均给予西医基础治疗,治疗组在此基础上加服糖肾康颗粒。两组疗程均为8周。观察两组患者临床疗效、治疗前后24 h尿蛋白定量(U-Pro/24 h)、尿白蛋白与肌酐比值(MA/Cr)及血清C反应蛋白(CRP)、IL-6、IL-18的水平变化。结果治疗组临床疾病总有效率和中医证候疗效总有效率分别为86.67%和93.33%,优于对照组的63.33%和60.00%(P<0.05或P<0.01)。治疗组和对照组治疗后患者尿蛋白(U-Pro/24 h、MA/Cr)均较治疗前下降(P<0.05或P<0.01),但治疗组显著低于对照组(P<0.05)。治疗组与对照组治疗前血清CRP、IL-6、IL-18水平均显著高于正常组(P<0.01);治疗后两组血清CRP、IL-6、IL-18水平均较治疗前降低(P<0.05或P<0.01),且治疗组优于对照组(P<0.05)。结论糖肾康颗粒可显著改善DN气阴两虚证患者的临床症状,降低尿蛋白,其作用机制可能与降低血清CRP、IL-6、IL-18炎症因子的表达有关。

Objective： To observe the clinical effect of Tangshenkang Granules in treating DN （ diabetic nephropa- thy） patients of qi and yin deficiency and to explore its possible mechanism. Methods： Totally 60 cases of DN patients with qi and yin deficient syndrome were randomly divided into treatment group and control group, 30 cases in each, other 20 healthy persons being selected as the normal group. The Western basic therapy was given to both treatment and control groups, Tangshenkang Granules being added to the treatment group for 8-week duration. The clinical effect of patients in two groups, 24 h urinary protein quantitative （ U-Pro/24 h） before and after treatment, level changes of urinary albumin and ereatinine ratio （MA/Cr）, serum C reactive protein （CRP）, IL-6 and IL-18 were observed. Results： In the treat- ment group, the clinical total efficiency and the curative effective rate of different syndromes were 86.67 % and 93.33 % respectively better than 63.33 % and 60.00 % of the control group （P〈0.05 or P〈0.01 ）. The levels of U-Pro/24 h and MA/Cr in both treatment and control groups significantly decreased （P〈0.05 or P〈0.01 ）, but the treatment group was significantly lower than that of control group （P〈0.05）. The levels of CRP, IL-6 and IL-18 in both treatment and con- trol groups before treatment significantly higher than the normal group（ P〈0.01 ） ; while after treatment tho~ levels were markedly reduced （P〈0.05 or P〈0.01 ） and the treatment group was superior to the control group （P〈0.05）. Conclu- sion： Tangshenkang Granules can significantly improve the clinical symptoms of DN patients with qi and yin deficiency and decrease urinary protein, with its mechanism relevant to its function in reducing the expression of inflananatory factors as IL-6, CRP and IL-18.