参芪地黄汤对气阴两虚型早期糖尿病肾脏病患者血清炎症因子、肾功能及微循环的影响

Effect of Shenqi Dihuang decoction on inflammatory factor,renal function and microcirculation in patients with early diabetic nephropathy

为了探讨参芪地黄汤对气阴两虚型早期糖尿病肾脏病（DN）患者血清炎症因子、肾功能及微循环的影响，2014年3月-2016年4月期间，观察本院收治的205例罹患DN患者，以该批患者为研究对象，随机数字表法分为治疗组（103例）、对照组（102例）。对照组患者口服二甲双胍与卡托普利，并视临床症状调节剂量；治疗组给予参芪地黄汤进行治疗，每日1剂，分2次煎服，3个月为1个疗程结束。对2组患者临床疗效、血清炎症因子、肾功能指标、内皮细胞指标及血液流变学指标进行比较。发现治疗后2组患者总有效率分别为治疗组92．23％、对照组77．45％，治疗组疗效明显优于对照组（P〈0．05）；白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤细胞因子（TNF-α）、C反应蛋白（CRP）水平明显降低（P〈0．05），治疗组各值均明显低于对照组（P〈0．05）；胆微球蛋白（β2-MG）、血清胱抑素-C（Cys-C）、尿微量白蛋白尿（m-ALB）均明显降低（P〈0．05），治疗组各值均明显低于对照组（P〈0．05）；血管内皮素（ET-1）水平均明显降低，治疗组各值明显低于对照组（P〈0．05）；一氧化氮（NO）水平明显升高，治疗组明显高于对照组（P〈0．05）；全血黏度、血浆黏度、纤维蛋白原、全m还原黏度及血小板聚集率均明显降低（P〈0．05），治疗组各值均明显低于对照组（P〈0．05）。结果表明参芪地黄汤可以干预早期DN患者的炎症反应，减轻患者蛋白尿，保护肾功能，并改善患者血管内皮功能与血液流变学，实现微循环的正常恢复。

To study the effect of Shenqi Dihuang decoction on inflammatory factor, renal function and microcirculation in patients with early diabetic nephropathy. A total of 205 cases of patient with early diabetic nephropathy treated in our hospital from March 2014 to April 2016 were selected and divided into two groups according to the admitted order, with 103 cases in chnical group and 102 in control group. Patients in control group were treated with melbine and captopril, which may be adjusted according to the clinical symp- tom. The clinical group was given Shenqi Dihuang decoction. Then the clinical efficady, inflammatory factors, renal function, endothe- lial function and hemorheology index were compared. Compared with 77.45% in the control group, the total effective rate of the clini- cal group was 92. 23%. There was a significant increase （P 〈 0. 05）. The comparison of the values of IL-6, IL-8, TNF-α and CRP between the two groups before and after treatment showed significant differences. The values of inflammatory factors in treatment group were lower than in control group （P 〈 0. 05）. The comparison of the values of β2-MG, Cys-C and urine m-ALB between the two groups before and after treatment showed significant differences. The values of renal function in treatment group were lower than those in con- trol group （ P 〈 0. 05 ）. Compared with before treatment, ET-1 of the two groups after treatment decreased, while NO increased （ P 〈0. 05 ）. Compared with the control group, the value of ET-1 in patients of the experimental group was lower after treatment, while NO was higher （P 〈 0. 05 ）. The comparison of the values of whole blood viscosity, plasma viscosity, whole blood reduction viscosity, platelet aggregation rate and fibrinogcn between the two groups before and after treatment showed significant differences. The value of hemorheology index in treatment group was lower than that in control group （P 〈 0. 05 ）. Shenqi Dihuang decoction has a better effect on patients with early diabetic nephropathy. It can significantly intervene with inflammatory response, reduce proteinuria, protect the renal function of patients, and improve the patientg vascular endothelial function and blood rheology, so as to make microcirculation to recover to the normal level.