复方灵芝健肾汤对早期糖尿病肾病氧化应激反应和内皮功能的影响

Influence of the Fu Fang Ling Zhi Jian Shen Tang on oxidative stress and endothelial function in early diabetic nephropathy

目的观察复方灵芝健肾汤联合雷公藤多苷片对早期糖尿病肾病(DN)患者氧化应激反应及内皮功能的影响。方法将126例早期DN患者随机分为观察组和对照组,各63例。两组均接受基础治疗;对照组给予雷公藤多苷片治疗,观察组在对照组基础上加用复方灵芝健肾汤。观察两组血清肌酐(SCr)、尿素氮(BUN)、尿白蛋白排泄率(UAER)、丙二醛(MDA)、超氧化物歧化酶(SOD)以及一氧化氮(NO)、血管性血友病因子(v WF)和内皮素-1(ET-1)浓度变化,比较两组的临床疗效和中医症候积分。结果治疗后两组中医症候积分明显低于治疗前(P <0. 01),观察组明显低于对照组(P <0. 01);治疗后两组SCr、BUN、UAER明显低于治疗前(P <0. 01),观察组明显低于对照组(P <0. 01);观察组患者临床疗效高于对照组(P <0. 05);治疗后两组MDA、v WF、ET-1明显低于治疗前(P <0. 01),观察组明显低于对照组(P <0. 01);治疗后两组SOD、NO明显高于治疗前(P <0. 01),观察组明显高于对照组(P <0. 01)。结论复方灵芝健肾汤联合雷公藤多苷片能够缓解早期DN的氧化应激反应,减轻血管内皮细胞的损伤,改善肾功能,减轻临床症状。

Objective To observe the influence of Fu Fang Ling Zhi Jian Shen Tang combined with tripterygium wilfordii tablet on oxidative stress and endothelial function of patients with early diabetic nephropathy（DN）. Methods One hundred and twenty-six of patients with early DN were divided into observation group and control group according to random number table method,63 cases in each group.Besides receiving the basic intervention for controlling blood pressure and sugar,the control group received the tripterygium wilfordii tablet and the observation group received the tripterygium wilfordii tablet plus the Fu Fang Ling Zhi Jian Shen Tang.In order to evaluate the curative efficacy of the medicine,the serum concentrations of creatinine（SCr）,urea nitrogen（BUN）,urinary albumin excretion rate（UAER）,malondialdehyde（MDA）,superoxide dismutase（SOD）,nitric oxide（NO）,von Willebrand factor（vWF）and endothelin-1（ET-1）,as well as the TCM syndrome scores and clinical effectiveness were examined in both groups. Results After treatment,TCM syndrome scores were significantly declined in both groups compared with those before treatment（ P 〈0.01）,and the score in the observation lessen much more than the control group（ P 〈0.01）.In the two groups the serum concentrations of SCr,BUN and UAER decreased significantly compared with those before treatment（ P 〈0.01）,and the changed magnitudes in the observation group were more obvious than the control（ P 〈0.01）.The total clinic effective rate of the observation group revealed a better result compared with the control group（ P 〈0.05）.The serum concentrations of MDA、vWF and ET-1 decreased significantly compared with their pretreatment owns（ P 〈0.01）,and the observation group had lower levels of MDA、vWF and ET-1 than the control group（ P 〈0.01）.After treatment,the both groups obtained higher concentrations of SOD and NO than their pretreatment（ P 〈0.01）,and the observation group appeared markedly higher levels in the both substances than the control（ P 〈0.01）. Conclusion The Fu Fang Ling Zhi Jian Shen Tang assisted with the tripterygium wilfordii tablet effectively alleviated oxidative stress,repaired endothelial function and improved renal function and clinical symptoms in the patients with early DN.