詹锐文教授经验方“早肾方”治疗糖尿病肾病临床效果及部分机制

Clinical Observation on Professor Zhan Ruiwen's Experience Prescription “Zaoshen Decoction” in the Treatment of Diabetic Nephropathy and Part of the Mechanism Discussion

目的:观察"早肾方"对糖尿病肾病的临床疗效并探究该汤方部分作用机制。方法:选取2016年1月至2017年1月湛江市第一中医医院收治的糖尿病肾病患者90例,随机分成对照组和观察组,每组45例。2组患者均接受内科常规治疗,观察组在常规治疗基础上加用"早肾方",均持续治疗8周,疗程结束后比较2组患者中医证候积分、血糖、肾功能、肾段动脉收缩期血流峰值速度(V_(max))、舒张期血流峰值速度(V_(min))、阻力指数(RI)、以及血清抗衰老蛋白水平的变化。结果:治疗后2组患者中医证候积分均有所下降,其中观察组下降的趋势更为明显(P<0.05)。治疗后2组血肌酐(Scr)、尿素氮(BUN)、24 h蛋白尿、尿微量白蛋白(MA)、基化血红蛋白(Hb A_(lc))、餐后2 h血糖(FPG)均较治疗前有所下降,观察组下降的幅度较对照组明显(P<0.05)。2组治疗后V_(max)、V_(min)明显高于治疗前,RI均较治疗前降低,观察组与对照组比较,差异有统计学意义(P<0.05)。与对照组比较,"早肾方"更可明显上调血清抗衰老蛋白水平,差异均有统计学意义(P<0.05)。结论:"早肾方"可有效治疗糖尿病肾病,其作用机制可能与上调血清抗衰老蛋白有关。

Objective：To observe the clinical curative effects of the Zaoshen decoction on diabetic nephropathy and to explore the mechanism of action.Methods：A total of 90 cases of diabetic nephropathy in our hospital during January 2016 to January 2017 included into the research were randomly divided into the control group and the observation group,with 45 cases in each group.Both groups were treated with conventional medical treatment,and the observation group was added＂Zaoshen decoction＂on the basis of conventional treatment.The treatment continued for 8 weeks.After treatment,the changes of TCM syndrome integrals,blood glucose,renal function,renal artery peak systolic velocity（Vmax）,peak diastolic velocity（Vmin）,resistance index（RI）,and serum anti-aging protein of two groups were compared.Results：1）TCM syndrome integrals of the two groups decreased after treatment,and the downward trend of the observation group was more significant（P〈0.05）.2）Serum creatinine（Scr）,urea nitrogen（BUN）,24 h proteinuria,urinary microalbuminuria（MA）,hemoglobin（Hb Alc）,postprandial 2 hours blood glucose（FPG）were decreased in the two groups after treatment.The decrease of the observation group were more significantly than the control group（P〈0.05）.3）After treatment,Vmax and Vmin of the two groups were significantly higher than before the treatment,and RI was reduced compared before the treatment.There was statistically significant difference between the observation group and control group（P〈0.05）.4）Compared with the control group,the＂Zaoshen decoction＂increased the serum anti-aging protein more significantly,and the differences were with statistical significance（P〈0.05）.Conclusion：＂Zaoshen decoction＂can effectively treat diabetic nephropathy,whose mechanism may be related to the up-regulation of serum anti-aging protein.