二黄参苓合剂联合治疗早期糖尿病肾病气阴两虚夹痰瘀证的疗效与机制探讨

Effect and Discussion on Mechanism of Erhuang Shenling Mixture in Conbined Treatment of Early Diabetic Nephropathy with Qi-Yin Deficiency with Phlegm-Stasis Sydrome Type

目的:观察二黄参苓合剂联合治疗早期糖尿病肾病气阴两虚夹痰瘀证的疗效及探讨其机制。方法:将60例患者随机分成对照组和观察组,两组各30例,两组均予以基础治疗,包括糖尿病教育、饮食控制、运动干预及常规降糖治疗,观察组联合基础治疗同时加用二黄参苓合剂,疗程4周。观察两组治疗前后中医证候积分、血糖血脂、尿微量白蛋白、尿白蛋白/尿肌酐、血清TGF-β1、Smad3、Smad7等变化。结果:观察组在改善中医症状、中医证候总积分、血糖血脂、尿白蛋白/尿肌酐等指标优于对照组,差异有统计学意义(P<0.05);两组均能有效降低血清TGF-β1、Smad3含量、升高Smad7水平(P<0.05),且在降低TGF-β1、升高Smad7方面,观察组优于对照组(P<0.05)。结论:二黄参苓合剂能显著改善早期糖尿病肾病气阴两虚夹痰瘀证患者的临床症状,且通过抑制TGF-β/Smad信号转导通路改善糖脂代谢,延缓糖尿病肾病进展。

Objective： To observe and discuss the mechanism of Erhuang Shenling Mixture in conbined treatment of early diabetic nephropathy with qi-yin deficiency with phlegm-stasis sydrome type. Method： Sixty patients were randomly divided into observation group and control group,there were 30 patients in each group. Both groups received foundation treatment,including diabetes education diet and exercise intervention,conventional hypoglycemic treatment. On the basis of foundation treatment,the observation group combined with Erhuang shenling mixture,four weeks as a course of treatment. After treatment,Observe the change of TCM syndrome integral,blood sugar blood lipid,UALB,UACR,serum TGF-β1,Smad3,Smad7. Results： The observation group was better than the control group in improving the symptoms,TCM syndrome integral,blood glucose,blood lipid,urinary albumin/urine creatinine,and the difference was statistically significant（P 0. 05）. Both groups could decrease the serum TGF-β1,Smad3,while increase the Smad7（P 0. 05）,and the observation group were better than the control group in reducing the serum TGF-β1 and increasing Smad7（P 0.05）. Conclusion： Erhuang shenling mixture can improve clinical symptoms significantly in patients with early diabetic nephropathy with Qi-yin deficiency with phlegm-stasis sydrome type. Through suppressing TGF-β/Smad signaling pathways,Erhuang shenling mixture can improve glucolipid metabolism,delay the process of diabetic nephropathy.