肾芪Ⅰ号对早中期气阴两虚夹瘀证糖尿病肾病患者尿mindin、nephrin蛋白的影响

Effects of “Shenqi No.Ⅰ” on Urinary Nephrin and Mindin Proteins in Patients with Diabetic Nephropathy at Early and Middle Stage of Qi-yin Deficiency with Blood Stasis Syndrome

目的:观察肾芪Ⅰ号结合西医常规疗法治疗气阴两虚夹瘀型糖尿病肾病(DN)的临床疗效及其对患者尿nephrin、mindin蛋白的影响。方法:纳入80例气血两虚夹瘀型早中期DN患者,随机分为治疗组(44例)和对照组(36例)。对照组患者给予西医常规治疗,治疗组患者在西医常规治疗同时加服肾芪Ⅰ号,两组疗程均为6个月。评价两组患者的中医证候临床疗效,比较两组患者尿nephrin、mindin蛋白浓度变化情况。结果:(1)治疗后,治疗组的中医证候疗效总有效率为81.8%,对照组为52.8%,两组比较差异有统计学意义(P<0.01),治疗组的疗效优于对照组。(2)治疗后,治疗组患者的尿mindin蛋白浓度显著降低(P<0.05),尿nephrin蛋白浓度明显升高(P<0.05);且治疗组患者的尿mindin蛋白浓度低于对照组(P<0.05),尿nephrin蛋白浓度高于对照组(P<0.05)。结论:肾芪Ⅰ号结合西医常规疗法治疗气阴两虚夹瘀型早中期DN,可有效改善患者的中医证候,同时对肾小球足细胞具有一定的保护作用,减轻肾小球滤过膜的损伤。

Objective： To observe the clinical efficacy of ＂Shenqi No. I ＂ combined with routine western medicine in the treatment of diabetic nephropathy （DN） of qi-yin deficiency with blood stasis syndrome and its influence on urinary nephrin and mindin proteins. Methods： Eighty patients with DN at early and middle stage of qi-yin deficiency with blood stasis syndrome were selected and randomly divided into the treatment group （44 eases） and control group （36 cases）. The patients in the control group were treated with routine western medicine and the patients in the treatment group were treated with routine western medicine combined with ＂ Shenqi No. I ＂, with a course of 6 months. The clinical efficacy of Chinese medical syndrome was evaluated and the concentrations of urinary nephrin and mindin proteins were detected and compared. Results： （1）After treatment, the total effective rates on Chinese medical syndrome of the treatment group and the control group were 81.8% and 52.8% respectively, with statistical difference between the two groups （P 〈 0.01 ）, and the efficacy of the treatment group was superior to the control group. （2） After treatment, the concentration of urinary mindin protein was significantly decreased in the treatment group （ P 〈 0.05 ）, and the concentration of urinary nephrin protein was obviously increased （ P 〈 0.05 ） ; the concentration of urinary mindin protein in the treatment group was lower than that in the control group （P 〈 0.05） and the concentration of urinary nephrin protein in the treatment group was higher than that in the control group （P 〈 0. 05 ）. Conclusion： ＂Shenqi No. I ＂ combined with routine western medicine can improve the Chinese medical syndrome, protect the glomerular podocyte and reduce the glomerular filtration membrane damage in the treatment of DN at early and middle stage of qi-yin deficiency with blood stasis syndrome.