补肾活血去癖方对糖尿病肾病患者肾小管重吸收的影响

Effect of Bushen Huoxue Qupi rescription on renal tubule reabsorption in patients with diabetic nephropathy

目的探讨自拟补肾活血去癖方对糖尿病肾病患者肾小管重吸收的影响。方法选择Ⅲ、Ⅳ期糖尿病肾病患者80例,按随机数字表法分为两组,每组40例,观察组给予补肾活血去癖方治疗,每天1剂,持续治疗3个月,对照组接受常规降糖、降压、调脂等治疗。比较两组治疗前、后的中医证候评分,以及肾小管功能、血清纤维化指标。结果观察组治疗后中医证候积分有效率高于对照组,差异有统计学意义(χ2=4.59,P<0.05);观察组患者治疗后的β2微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、N-乙酰-β-D葡萄糖苷酶(NAG),以及血清Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、层黏连蛋白(LN)均低于对照组治疗后,差异均有统计学意义(t分别=2.06、6.17、2.82、12.60、14.13、14.03、6.91,P均<0.05);但两组患者治疗后的血清肌酐(Scr)、24 h尿蛋白定量、NH4+比较,差异均无统计学意义(t分别=0.00、0.40、0.02,P均>0.05)。结论补肾活血去癖方可缓解糖尿病肾病患者临床症状,改善肾小管重吸收功能,并对肾纤维化有一定的抑制作用。

Objective To investigate the effect of self-made Bushen Huoxue Qupi rescription on renal tubule reabsorption in patients with diabetic nephropathy.Methods Totally 80 patients with stageⅢandⅣDN were divided into two groups with 40 cases in each according to the random number table method.The observation group received Bushen Huoxue Qupi rescription,1 dose per day.The course was 3 months.The control group received routine hypoglycemic,hypotensive and lipidregulating treatment.The scores of TCM syndrome,renal tubular function and serum fibrosis indexes were compared between two groups before and after treatment.Results The effective rate of TCM syndrome score in the observation group was significantly higher than that in the control group(χ2=4.59,P<0.05).After the treatment,the levels ofβ2-MG,RBP,NAG,PCⅢ,Ⅳ-C,HA,and LN of the observation group were significantly lower than those of the control group(t=2.06,6.17,2.82,12.60,14.13,14.03,6.91,P<0.05).But there was no significant difference in Scr,24 hours urine protein quantitative and NH4+between the two groups(t=0.00,0.40,0.02,P>0.05).Conclusion Bushen Huoxue Qupi rescription can relieve the clinical symptoms of DN patients,improve renal tubular reabsorption and have a certain inhibitory effect on renal fibrosis.