黄葵胶囊抑制Ⅲ～Ⅳ期糖尿病肾脏疾病患者氧化应激及纤维化的作用

Effect and mechanism of Huangkui capsule inhibiting oxidative stress and fibrosis indicators in patients with diabetic nephropathy with stage Ⅲ-Ⅳ

目的研究黄葵胶囊对Ⅲ～Ⅳ期糖尿病肾脏疾病患者(DKD)肾组织氧化应激及纤维化的抑制作用,探究黄葵胶囊治疗DKD的机制。方法将2014年6月至2015年10月在华中科技大学同济医学院附属梨园医院就诊的Ⅲ～Ⅳ期DKD患者100例采用随机数字表法分为两组,每组50例。对照组给予降血糖、降血脂等常规治疗,治疗组在常规治疗基础上加予黄葵胶囊(口服,5粒/次,tid),持续治疗3个月检测并比较两组患者治疗前后肾功能指标、尿液指标、血清氧化应激及纤维化指标变化。结果治疗后两组血肌酐、尿素氮、β2微球蛋白水平均显著降低,内生肌酐清除率显著升高,且两组间比较差异具有统计学意义(P<0.05);两组治疗后尿白蛋白排泄率、24h尿蛋白定量低于治疗前,且治疗组均显著低于对照组,差异有统计学意义(P<0.05);两组治疗后丙二醛、骨髓过氧化物酶浓度低于治疗前,而氧化物歧化酶活性高于治疗前,且治疗后两组间比较差异有统计学意义(P<0.05);两组治疗前、后8-羟化脱氧鸟苷比较差异无统计学意义(P>0.05);治疗后两组血清Ⅳ型胶原、Ⅲ型前胶原、层黏过蛋白、透明质酸水平均显著低于治疗前,且治疗组显著低于对照组,差异比较有统计学意义(P<0.05)。结论黄葵胶囊具有拮抗肾组织氧化应激损伤的作用,其机制可能是通过影响致纤维化因子的释放而改善肾纤维化。

Objective To study the effect of Huangkui capsule inhibiting oxidative stress and fibrosis index in patients with diabetic kidney disease（DKD）with stageⅢ-Ⅳ,so as to explore the mechanism of Huangkui capsule in the treatment of DKD.Methods 100 patients with DKD with stageⅢ-Ⅳfrom June 2014 to October 2015 were randomly divided into two groups,50 in each group.The patients in the control group were given conventional treatment,and those in the treatment group additionally received Huangkui capsule orally,5 capsules each time,3 times every day for 6 months.The kidney function,and urine and serum levels of oxidative stress and fibrosis indicators were detected.Results The SCr,BUN,andβ2-MG levels in two groups after treatment decreased,CCr increased,and there was statistically significant significance between two groups（P〈0.05）.The UAER and 24-h urine proteinin two groups after treatment were significantly lower than those before treatment,and those in the treatment group were significantly lower than those in the control group（P〈0.05 for all）.The MDA and MPO concentrations intwo groups after treatment were significantly lower than before treatment,SOD activity was significantly higher than before treatment,and there was statistically significant difference between two groups（P〈0.05）.There was no statistically significant difference in 8-OHdG in two groups before and after treatment（P〈0.05）.The serum IV-C,PC Ⅲ,LN and HA levels after treatment in two groups were significantly lower than before treatment,and those in study group were significantly lower than those in the control group（P〈0.05 for all）.Conclusions Huangkui capsule can antagonize the oxidative stress injury in kidney tissues probably by influencing the release of fibrosis factor and improving the renal fibrosis.