糖肾康对糖尿病肾病气阴两虚血瘀证患者血清MCP-1和ICAM-1水平的影响

Effects of Tangshenkang on the MCP-1,ICAM-1 of Diabetic Kidney Disease with Qi-Yin Eficiency and Blood Stasis Syndrome

目的观察糖肾康对糖尿病肾病(DN)气阴两虚血瘀证患者血清单核细胞趋化性蛋白-1(MCP-1)、细胞间粘附分子-1(ICAM-1)指标的影响,研究糖肾康对其干预作用。方法将66例Ⅲ-Ⅳ期DN气阴两虚血瘀证患者随机分为两组(治疗组33例,对照组33例),失访3例,实际完成治疗组32例和对照组31例,并设正常组20例。对照组给予常规降糖、降压治疗,治疗组在对照组基础上加用糖肾康,两组疗程均为8周。观察临床疗效、治疗前后尿白蛋白/尿肌酐(ACR)、血清MCP-1及ICAM-1水平的变化情况。结果治疗组临床疗效优于对照组(P<0.01);治疗后两组ACR水平均降低(P<0.01),治疗组下降幅度优于对照组(P<0.01)。血清MCP-1、ICAM-1水平均较正常组显著升高(P<0.01);治疗后,治疗组和对照组均能降低MCP-1、ICAM-1水平(P<0.01),治疗组下降幅度均优于对照组(P<0.05)。结论糖肾康可改善气阴两虚血瘀证DN患者的临床症状,减少尿蛋白,降低血清MCP-1、ICAM-1水平,从而抑制免疫炎症反应,具有保护肾脏、延缓肾脏病进程的作用。

Objective To observe serum MCP-1 , ICAM-1 levels and the therapeutic effect of Tangshenkang granules of diabetic kidney disease with Qi-Yin eficiency and blood stasis syndrome. Methods 66 cases of patients with Qi-Yin eficiency and blood stasis syndrome were randomly divided into treatment group and control group , the actual completion of 63 cases , 32 cases in treatment group , 31 cases in the control group; and a healthy normal group of 20 cases of patients was established. Two groups of patients were given Conventional hypoglycemic and antihypertensive therapy , in addition , Tangshenkang was plused in treating at treatment group and it was used three times a day, each time blunt one bag. The course of treatment was 8 weeks. The changes of clinical efficacy, urinary albumin/ urine creatinine （ACR）, serum MCP-1 and ICAM-1 levels were observed in two groups of patients. Results The total effective rate in treatment group was significantly better than the control group（P〈0.01）. After treatment, the levels of ACR in treatment group and control group were significantly lower （P〈0.01）, and the treatment group was better than control group （P〈0.01）. Serum MCP-1 and ICAM-1 levels were significantly higher than those of the normal group（P〈0.01）; after treatment, the treatment group and the control group can reduce the level of MCP-1 and ICAM-1 （P〈0.01）, the treatment group decreased were better than the control group （P〈0.05）. Conclusion Tangshen can significantly improve the clinical symptoms and blood stasis in patients with DN, reduce urinary protein , serum MCP-1 and ICAM-1 levels , inhibition immune inflammatory response , can protect the kidney , delaying kidney disease course.