解毒通络保肾汤辅助治疗糖尿病肾病对患者血浆FGF-21水平及胰岛素敏感性的影响分析

Effect of treatment with Jiedu Tongluo Baoshen Decoction for diabetic nephropathy on plasma FGF-21 level and insulin sensitivity

目的:分析解毒通络保肾汤辅治疗糖尿病肾病对患者血浆FGF-21水平及胰岛素敏感性的影响。方法:选取2015年7月～2017年7月我院收治的106例糖尿病肾病患者,随机数字表法分为观察组和对照组,每组53例。对照组给予盐酸贝那普利治疗,观察组在对照组基础上服用解毒通络保肾汤辅助治疗,两组治疗后观察患者疗效以及治疗前后患者FGF-21、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素敏感性包括胰岛素抵抗和分泌指数及血脂、肾脏指标变化情况,并记录不良反应。结果:治疗后观察组总有效率显著高于对照组(P<0. 05)。与治疗后对照组比较,观察组血浆FGF-21水平、FPG、FINS、HbA1c显著下降(P <0. 05)。治疗后观察组HOMA-IR显著低于对照组(P <0. 05),而HOMA-IS显著高于对照组(P <0. 05)。治疗后观察组TG、TC、LDL、mA1b、24hU-TP、GFR显著低于对照组(P<0. 05)。结论:解毒通络保肾汤辅治疗效显著,能有效降低血浆FGF-21水平,增强胰岛素敏感性,改善肾功能作用。

Objective:To analyze the effect of treatment with Jiedu Tongluo Baoshen Decoction for diabetic nephropathy(DN)on plasma FGF-21 level and insulin sensitivity.Methods:106 patients with DN who were admitted to the hospital during the period from July 2015 to July 2017 were divided into the observation group and the control group,with 53 cases in each group.The control group was treated with benazepril hydrochloride,and on this basis,the observation group was treated with Jiedu Tongluo Baoshen Decoction.The therapeutic effects,changes in FGF-21,fasting plasma glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),insulin sensitivity(insulin resistance and secretion index),blood lipids and renal indicators in both groups before and after treatment were observed.Adverse reactions were recorded.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).The plasma FGF-21 level,FPG,FINS,HbA1c and HOMA-IR were significantly lower in the observation group than in the control group after treatment(P<0.05),while HOMA-IS was significantly higher than the control group(P<0.05).The TG,TC,LDL,mA1b,24 hU-TP and GFR in the observation group were significantly lower than those in the control group after treatment(P<0.05).Conclusion:Jiedu Tongluo Baoshen Decoction is significantly effective.It can effectively decrease the plasma FGF-21 level,enhance insulin sensitivity and improve renal function.