固本化瘀通络法对糖尿病肾病炎症因子的影响

Effect of Consolidating Body Resistance for Removing Blood Stasis and Removing Obstruction in Collaterals Therapy on the Proteinuria and Inflammatory Factors of Patients with Diabetic Nephropathy

目的观察中药固本化瘀通络法对糖尿病肾病(DN)患者的蛋白尿及相关炎症因子的影响,从而改善DN患者病情,延缓疾病进展。方法选择2015年6月—2016年6月在成都中医药大学附属医院肾病科住院和门诊的DN患者共76例,根据Mogensen诊断分期标准,将纳入患者分为两组(DN1:Mogensen III期;DN2:Mogensen IV期)。所有患者在常规治疗基础上,均使用中药固本化瘀通络方治疗12周,观察治疗前后DN患者肾功能、24小时尿蛋白定量及超敏C反应蛋白(hs CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果治疗前DN2组的hs CRP、IL-6、TNF-α水平明显高于DN1组(P<0.05),与治疗前比较,两组治疗后的炎症因子水平均明显降低(P<0.05),两组患者经治疗后蛋白尿均明显减少,DN2组经治疗后肾功能有所改善,相关分析发现蛋白尿水平与hs CRP、IL-6水平正相关。结论中药固本化瘀通络法可抑制糖尿病肾病患者的炎症因子水平,改善体内的慢性炎症状态,从而减少蛋白尿、改善肾功能,延缓肾脏病情进展。

Objective To observe the effect of consolidating body resistance for removing blood stasis and removing obstruction in collaterals therapy on the proteinuria and inflammatory factors of patients with diabetic nephropathy for slowing the progress of disease. Methods 76 cases of diabetic nephropathy patients from department of nephrology of the affiliated hospital of Chengdu university of TCM between June2015 and June 2016 were selected,and they were divided into DN1 group and DN2 group according to the Mogensen＇s diagnostic and staging criteria,that is,Mogensen III stage patients classified as DN1 group and Mogensen IV stage ones as DN2. The consolidating body resistance for removing blood stasis and removing obstruction in collaterals therapy was applied to the patients for 12 weeks on the base of routine treatment and the level of renal function,24-hour urine protein quantitation,serum hs CRP,IL-6. The TNF-α was examined before and after treatment. Results The level of hs CRP,IL-6,TNF-α in DN2 group were significantly higher than DN1 ones（ P〈0. 05）. The level of hs CRP,IL-6,TNF-α and 24 h urine protein decreased significantly after treatment in two groups（ P〈0. 05）,and especially renal function improved in DN2 patients. Pearson analysis revealed the level of urine protein positive correlated with serum hs CRP and IL-6. Conclusion The consolidating body resistance for removing blood stasis and removing obstruction in collaterals therapy is of great significance for slowing the progress of disease for restraining the inflammatory state and reducing proteinuria in diabetic nephropathy.