补阳还五汤辅治早期糖尿病肾病的疗效及对肾纤维化、氧化应激反应的影响

Effect of Buyanghuanwu decoction on early diabetic nephropathy and its effect on renal fibrosis and oxidative stress response

目的探讨补阳还五汤辅助治疗早期糖尿病肾病(EDN)的疗效及对肾纤维化、氧化应激反应的影响。方法回顾性分析陕西中医药大学附属医院2017年5月-2018年5月收治的EDN患者68例,按治疗方案不同分为常规西药治疗的西药对照组(n=35)、接受常规西药联合补阳还五汤治疗的补阳还五汤组(n=33),疗程均为8周。对比2组患者的近期疗效及肾纤维化、氧化应激反应程度差异。结果治疗8周后,补阳还五汤组总有效率高于西药对照组(96.97%vs. 80.00%,χ~2=4.712、P=0.030);补阳还五汤组患者血清中肾纤维化指标层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)的含量低于西药对照组(t=3. 611、5. 234、4. 884、5. 366,P均=0. 000);血清中过氧化物酶(MPO)、丙二醛(MDA)含量低于西药对照组,谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)的量高于西药对照组(t=12.306、4. 536、-6. 61、-3. 884,均=0. 000)。结论 EDN患者在西药治疗基础上加入中药补阳还五汤进行辅助治疗,可进一步提升近期疗效,且有助于抑制机体肾纤维化及氧化应激程度。

Objective To explore the curative effect of Buyanghuanwu decoction on early diabetic nephropathy (EDN) and its effect on renal fibrosis and oxidative stress. Methods A retrospective analysis was made of 68 patients with EDN admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2017 to May 2018. According to different treatment schemes,68 patients were divided into two groups: the control group ( n =35) treated with conventional western medicine and the Buyanghuanwu decoction group ( n =33) treated with conventional western medicine combined with Buyanghuanwu decoction. The course of treatment was 8 weeks. The short-term efficacy,renal fibrosis and oxidative stress were compared between the two groups. Results After 8 weeks of treatment,the total effective rate of Buyanghuanwu decoction group was higher than that of Western medicine control group (96.97% vs. 80.00%,χ^2 = 4.712,P =0.030);the serum levels of laminin (LN),hyaluronic acid (HA),type III procollagen (PCIII),type IV collagen (IVC) of Buyanghuanwu decoction group were lower than those of Western medicine control group ( t =3.611,t =5.234,t =4,t =5.366,P =0.000). The levels of serum peroxidase (MPO),malondialdehyde (MDA) and glutathione peroxidase (GSH Px) and superoxide dismutase (SOD) were lower than those of Western medicine control group ( t =12.306,t =4.536,t =-6.161,t =-3.884,P =0.000). Conclusion Adding Buyanghuanwu decoction (BYHWD) to EDN patients on the basis of Western medicine treatment can further improve the short-term efficacy,and help to inhibit the degree of renal fibrosis and oxidative stress.