益气养阴化浊通络方对早期糖尿病肾病患者NF-κB、MCP-1及IL-6的影响

The Influence of Yiqi Yangyin Huazhuo Tongluo Decoction on Nuclear Factor-Kappa B and Monocyte Chemotactic Protein-1 and Interleukin-6 of Patients with Early Diabetic Kidney Disease

目的:观察益气养阴化浊通络方对早期糖尿病肾病(diabetic kidney disease,DKD)患者血清核因子-κB(NF-κB)、单核细胞趋化蛋白-1(MCP-1)及白介素-6(IL-6)的影响。方法:选取2013年9月—2014年12月南阳理工学院附属医院、邓州市第二人民医院收治的DKD患者70例,按照随机数字表法分成对照组和治疗组,每组35例。治疗组因治疗上有变动等退出2例。对照组给予糖尿病饮食、运动、降血糖等常规对症治疗,治疗组在对照组治疗的基础上加服益气养阴化浊通络方治疗。采用酶联免疫吸附法(ELISA)测定两组患者治疗前后血清NF-κB、MCP-1和IL-6水平,同时观察CRP、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、24 h尿蛋白、尿微量白蛋白排泄率(UAER)的变化情况。结果:治疗组有效率93.94%,对照组有效率74.29%,治疗组优于对照组(P<0.05);两组治疗后Hb A1c、24 h尿蛋白、UAER、CRP、NF-κB、MCP-1和IL-6水平均较治疗前明显降低(P<0.05或P<0.01),且治疗组治疗后24 h尿蛋白、UAER、CRP、NF-κB、MCP-1和IL-6水平优于对照组(P<0.05或P<0.01);早期DKD患者NF-κB、MCP-1、IL-6、CRP水平与UAER呈正相关性(P<0.05或P<0.01)。结论:益气养阴化浊通络方能够减轻早期糖尿病肾病患者炎症反应,减少蛋白尿,延缓病情进展。

Objective： To observe the influence of Yiqi Yangyin Huazhuo Tongluo Decoction（ YQYYHZTLD） on nuclear factorkappa B and monocyte chemotactic protein-1 and interleukin-6 of patients with early diabetic kidney disease. Methods： Seventy patients who were treated in Affiliated Hospital of Nanyang Institute of Technology and Dengzhou City No. 2 People＇s Hospital between Sept. of 2013 and Dec. of 2014 were chosen as the research objects,and divided into the control group and the treatment group according to random number table method,with 35 cases in each group. Two cases dropped out from the treatment group for some medical reason. The ones in the control group were given routine symptomatic treatment including diabetes diet,exercise,reducing blood sugar,while the ones in the treatment group were added YQYYHZTLD based on the treatment of the control group. Then the two groups＇ serum NF-κB,MCP-1 和 IL-6 levels before and after the treatment were measured by using ELISA;At the same time,changes of CRP,FBG,Hb A1c）,24-h urine protein,and UAER were observed. Results： The effective rate of the treatment group was 93. 94%,while that of the control group was 74. 29%; And the treatment group was better than the control group（ P〈0. 05）. After the treatment,the two groups＇ levels of Hb A1 c,24-h urine protein,UAER,CRP,NF-κB,MCP-1 and IL-6 were all much reduced than those before the treatment（ P〈0. 05 or P〈0. 01）; And the levels of 24-h urine protein,UAER,CRP,NF-κB,MCP-1 and IL-6 of the treatment group were all better than those of the control group（ P〈0. 05 or P〈0. 010）. NF-κB,MCP-1,IL-6 and CRP levels of patients at early stage had positive correlation with UAER（ P〈0. 05 or P〈0. 01）. Conclusion： YQYYHZTLD can relieve the inflammatory reactions of patients with early diabetic kidney disease,reduce urine protein,and delay the disease development.