补肾活血方对气阴两虚兼血瘀型DN患者血清胰岛素样生长因子-1、超敏C反应蛋白及血液流变学的影响

Effects of Bushen Huoxue Decoction on the Level of IGF-1,hs-CRP and Blood Rheology of Patients with Diabetic Nephropathy of Deficiencies of Qi and Yin and Blood Stasis Syndrome

目的:探讨补肾活血方对气阴两虚兼血瘀型糖尿病肾病(DN)患者血清胰岛素样生长因子-1(IGF-1)、超敏C反应蛋白(hs-CRP)及血液流变学的影响。方法:选取2015年5月至2016年9月安阳市中医院收治的早期DN患者86例,根据治疗方法,分为对照组和观察组,每组43例。对照组给予常规治疗,并口服贝纳普利,在对照组的基础上,观察组给予补肾活血方治疗。治疗12周后,观察2组的疗效,并对比治疗前后空腹血糖(FBG)、餐后血糖(PBG)、糖化血清蛋白(GSP)、血清IGF-1、血清hs-CRP及血液流变学指标。结果:2组的总有效率比较,差异有统计学意义(P<0.05);与治疗前比较,2组治疗后的FBG、PBG、UAER及GSP均显著性下降(P<0.05),且观察组下降程度更大(P<0.05);与治疗前比较,2组治疗后的血清IGF-1、hs-CRP均下降(P<0.05),且观察组下降程度更大(P<0.05);与治疗前比较,对照组治疗后的血液流变学指标差异无统计学意义(P>0.05),观察组治疗后的血液流变学指标显著降低(P<0.05),2组差异有统计学意义(P<0.05)。结论:补肾活血方治疗气阴两虚兼血瘀型糖尿病肾病患者的临床疗效较好,有效控制血糖,降低血清IGF-1、hs-CRP含量,抑制炎性反应,促进血液循环。

Objective： To investigate the effect of Bushen Huoxue decoction on the level of IGF-1, hs-CRP and blood rheology in patients with deficiencies of qi and yin and blood stasis type of diabetic nephropathy. Methods： The clinical date of 90 cases of patients with deficiencies of qi and yin and blood stasis type of diabetic nephropathy were retrospectively analyzed during May 2015 to September 2016, and according to treatment method, they were divided into control group and research group. All patients were given hypoglycemic, control of blood pressure and blood fat, anti-inflammatory and other conventional treatment. On the basis of conventional treatment, the control group were given oral boehner simplex, and research group were given Bushen Huoxue decoction on the basis of control group. After treatment of 12 weeks, the curative effect of two groups was observed before and after treatment. Fasting blood glucose, postprandial blood glucose, glycosylated serum protein, IGF-1, hs-CRP and blood rheology indexes were compared. Results： 1）After treatment, total effective rate of research group was 88.37%; total effective rate of control group was 69.77%; with significant difference （χ 2=10.024, P =0.007〈0.05）; 2）FBG, PBG, UAER and GSP after treatment in two groups was decreased, and the difference was statistically significant （ P 〈0.05）. And FBG, PBG, UAER and GSP after treatment in research group were lower than control group, with statistically significant difference （ P 〈0.05）; 3）After treatment, IGF-1, hs-CRP in two groups was decreased with statistically significant difference （ P 〈0.05）, and IGF-1, hs-CRP after treatment in research group were more lower than control group with statistical significance （ P 〈0.05）; 4）There was no obvious difference for blood rheology indexes in control group between after treatment and before treatment （ P 〉0.05）, and hemorheology indexes after treatment in research group was reduced. The difference was statistically significant （ P 〈0.05）; hemorheology index after treatment in research group was lower than control group with statistically significant difference （ P 〈0.05）. Conclusion： The effect of Bushen Huoxue decoction in treatment of patients with deficiency of qi and yin and blood stasis type of diabetic nephropathy is significant, which can significantly reduce the blood sugar and serum IGF-1, hs-CRP, as well as improve blood rheology.