雷公藤多苷片对糖尿病肾病患者临床疗效及炎症因子水平影响研究

Effect of Tripterygium Wilfordii Polyglycoside on Inflammatory Factor Level in Patients with Diabetic Nephropathy

目的:观察雷公藤多苷片对糖尿病肾病患者临床疗效及炎症因子水平影响。方法:选取医院肾内科门诊及病房收治的糖尿病肾病患者72例,随机分为观察组与对照组,每组各36例。两组患者均给予常规一体化治疗,观察组在此治疗基础上予口服雷公藤多苷片,治疗6个月。比较两组患者治疗前后蛋白排泄率(UAER)、血肌酐(Scr)、肌酐清除率(Ccr)、CD_4^+、CD_8^+、IL-6(白介素6)及TNF-á(肿瘤坏死因子á)表达情况,并记录与治疗相关的不良反应。结果:治疗后,两组患者UAER表达均降低(P<0.05),观察组患者Ccr表达升高(P<0.05);其中观察组患者UAER、Ccr改善情况优于对照组(P<0.05)。治疗后,两组患者IL-6及TNF-á表达水平均下降,且观察组TNF-á表达水平低于对照组(P<0.05)。治疗后,观察组与对照组CD_4^+、CD_4^+/CD_8^+表达降低(P<0.05),CD_8^+表达升高(P<0.05);组间比较,观察组CD_4^+、CD_4^+/CD_8^+均低于对照组(P<0.05)。观察组不良反应发生率为13.89%,高于对照组的2.78%(P<0.05)。结论:雷公藤多苷片能够改善糖尿病肾病患者免疫失衡状态,抑制炎症因子表达,从而改善肾脏病理变化,减少尿蛋白的生成。且不良反应可控,具有良好的应用前景。

Objective：To observe the effect of tripterygium wilfordii polyglycoside on the level of inflammatory factors in patients with diabetic nephropathy.Methods：Seventy-two patients with diabetic nephropathy were randomly divided into observation group and control group,36 cases in each group.All patients were given conventional treatment,besides,patients in observation group were given tripterygium glycosides for 6 months.The levels of proteinuria（UAER）,serum creatinine（Scr）,creatinine clearance（Ccr）,CD4＋,CD8＋,IL-6 and TNF-α in the two groups were compared before and after treatment.Adverse events associated with treatment were recorded.Results：After treatment,the expression of UAER decreased in both groups（P〈0.05）,and the expression of Ccr in the observation group increased（P〈0.05）.The improvement of UAER and Ccr in the observation group was better than that in the control group（P〈0.05）.After treatment,the expressions of IL-6 and TNF-α decreased in both groups,and the expression of TNF-αin the observation group was lower than that in the control group（P〈0.05）.Compared with the control group,the expression of CD4＋ and CD4＋/CD8＋in the observation group and the control group decreased（P〈0.05） and the expression of CD8＋ increased（P〈0.05）.The adverse reaction rate was 13.89% in the observation group,which was higher than that 2.78% in the control group（P〈0.05）.Conclusion：Tripterygium wilfordii polyglycosides can improve immune imbalance and inhibit the expression of inflammatory factors in patients with diabetic nephropathyso as to improve renal pathological changes and reduce urinary protein production.The adverse reaction is controllable,and it has good application prospect.