健脾益肾养阴方联合血液透析对终末期糖尿病肾病患者胰岛素抵抗及炎症因子的影响

Study on Insulin Resistance and Serum Inflammatory Factors with End-stage Diabetic Nephropathy Patients Treated with Jianpi Yishen Yangyin Prescription Combined with Hemodialysis Method

目的探讨健脾益肾养阴方联合血液透析法治疗终末期糖尿病肾病对胰岛素抵抗程度及微炎症状态的影响。方法收集2016年7月—2017年12月终末期糖尿病肾病患者70例,随机分组为观察组与对照组,观察组给予健脾益肾养阴方联合血液透析法治疗,对照组给予常规血液透析治疗,比较两组患者空腹血(FBG)、FINS及稳态模型胰岛素抵抗指数(Homa-TR)变化情况,评价患者胰岛素抵抗程度;比较两组患者血清C反应蛋白(CRP)、肿瘤坏死因子-a(TNF-a)及白介素-6(IL-6)变化情况,评价患者微炎症指标变化情况。结果两组患者各指标经统计学分析,差异均有统计学意义(P <0. 05)。结果显示观察组治疗后胰岛素抵抗水平(FBG、FINS及Homa-IR)均明显低于对照组(P <0. 05);观察组治疗后血清CRP、TNF-a及IL-6水平均明显低于对照组(P <0. 05)。结论终末期糖尿病肾病患者采用健脾益肾养阴方联合血液透析法治疗,可改善患者胰岛素抵抗及炎症反应状况。

Objective To investigate the clinical analysis of insulin resistance and micro - inflammation in patients with end - stage diabetic nephropathy treated with Jianpi Yishen Yangyin prescription. Methods We collected 70 patients with end - stage diabetic nephropathy from July 2016 to December 2017. They were randomly divided into observation group and control group. The observation group was given JianpiYishen Yang Yin prescriptions for hemodialysis treatment in patients with end -stage diabetic nephropathy, and the control group was given routine hemodialysis in patients with end- stage dia- betic nephropathy. To compare the changes of fasting blood glucose （FBG） , FINS and Homa -TR in two groups of the obser- vation group and the control group to evaluate the degree of insulin resistance; to compare the serum C - reactive protein （CRP） between the two groups of patients in the observation group and the control group, Changes in tumor necrosis factor - a （ TNF - a） and interleukin - 6 （ IL - 6 ） evaluated changes in micro - imqammation markers. Results ： The indexes of the two groups were statistically analyzed, and the differences were statistically significant （ P 〈 0.05 ）. The Results showed that the insulin resistance levels （FBG, FINS and Homa - IR） in the observation group were significantly lower than those in the control group （P 〈 0.05 ）. The levels of serum CRP, TNF - a and IL -6 in the observation group were significantly lower than those in the control group （P 〈 0.05）. Conclusion The treatment of patients with end - stage diabetes mellitus using hemodialysis to treat Jianpi Yishen Yangyin prescription can improve insulin resistance and inflammation.