槐杞黄颗粒对糖尿病肾病的疗效及其机制研究

Therapeutic effect and mechanism of Huaiqihuang granules on diabetic nephropathy

目的观察槐杞黄颗粒对糖尿病肾病(DN)的疗效并探讨其可能机制。方法将120例DN患者随机分为对照组(60例)和试验组(60例),两组均给予常规治疗,在此基础上试验组增加槐杞黄颗粒治疗,共12周。观察两组患者治疗前后临床资料[收缩压(SBP)、舒张压(DBP)、BMI、空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、AST、ALT、血清白蛋白(Alb)水平]、尿蛋白、肾功能[24 h尿蛋白定量(24h Upro)、尿微量白蛋排泄率(UAER)、尿白蛋白/肌酐比值(UACR)、血肌酐(SCr)、尿素氮(BUN)、估算的肾小球滤过率(eGFR)]、炎症因子水平及氧化应激指标[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α、转化生长因子(TGF)-β1、核因子(NF)-κB、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]的变化。再将试验组患者分为Ⅲ期DN组23例和Ⅳ期DN组37例,比较两组患者UAER和eGFR水平。结果治疗后对照组和试验组患者UACR、24h Upro和UAER均较同组治疗前降低,且试验组患者上述指标均较观察组低(P<0.05)。Ⅲ期DN组和Ⅳ期DN组患者UAER水平在治疗后均较同组治疗前降低,Ⅲ期DN组患者UAER水平治疗前后均低于同期Ⅳ期DN组,eGFR均高于同期Ⅳ期DN组(P<0.05)。治疗后对照组和试验组患者炎症因子和MDA水平均较同组治疗前降低,且试验组低于对照组,两组患者SOD和GSH-px水平均较同组治疗前升高,且试验组高于对照组(P<0.05)。结论槐杞黄颗粒可能通过抑制炎症反应和减轻氧化应激降低DN患者尿蛋白水平。

Objective To study the therapeutic effect and possible mechanism of Huaiqihuang granules on diabetic nephropathy(DN).Methods A total of 120 patients with DN were randomly divided into the control group(60 cases)and the test group(60 cases).Both the two groups were given routine treatment,while test group was given the treatment of Huaiqihuang granules,a total of 12 weeks.Before and after treatment,the levels of clinical data[systolic blood pressure(SBP),diastolic blood pressure(DBP),BMI,fasting blood glucose(FPG),2 h postprandial blood glucose(2h PG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),AST,ALT,serum albumin(Alb)],urinary protein and renal function[24 h urinary protein quantity(24h Upro),urinary microalbumin excretion rate(UAER),urinary albumin/creatinine ratio(UACR),serum creatinine(SCr),urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)],inflammatory factors and oxidative stress indexes[interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α,transforming growth factor(TGF)-β1,nuclear factor(NF)-κB,malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)]were observed.Patients in test group were divided into stageⅢDN group(23 cases)and StageⅣDN group(37 cases).Levels of UAER and eGFR between the two groups were compared.Results After the treatment,the levels of UACR,24h Upro and UAER in both the control group and the test group were lower than those in the same group before the treatment,and the levels of above indexs in the test group were lower than those in the control group(P<0.05).After the treatment,the levels of UAER in patients of StageⅢDN group andⅣDN group were lower than those in the same group before treatment,before and after treatment,the level of UAER in StageⅢDN group was lower than that in the same period of stageⅣDN group,while the level of eGFR was higher than that in the same period of stageⅣDN group(P<0.05).After the treatment,the levels of inflammatory factors and MDA were lower than those in the same group before treatment,and the levels of abave indexs in the test group was lower than those in the control group,the levels of SOD and GSH-px were higher than those in the same group before treatment,and the levels of above indexs in the test group were higher than those in the control group(P<0.05).Conclusion Huaiqihuang granules may reduce the levels of urinary protein in patients with DN by inhibiting the inflammation and reducing oxidative stress.