黄芪注射液对DKD(CKD3期)患者氧化应激状态、胰岛素抵抗及肾功能的影响

Effects of Astragalus Injection on Antioxidant Capacity,Insulin Resistance and Renal Function in Patients with DKD(CKD3)

目的:探讨黄芪注射液对糖尿病肾脏病(DKD)慢性肾脏病(CKD)3期患者氧化应激状态、胰岛素抵抗及肾功能的影响。方法:选取2018年01月~2019年01月在我院肾内科病房及日间治疗室收治的DKD致CKD 3期患者80例,随机等分为两组,各40例。对照组采用饮食指导、适量运动、降糖及血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)类药物等常规治疗,治疗组在对照组基础上加用黄芪注射液治疗4周。观察治疗前后患者临床疗效、血清谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,检测血肌酐(Scr)、24 h尿蛋白(Upro)、血尿素氮(BUN)水平,检测患者治疗前后清晨空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及糖化血红蛋白(HbA1c)水平。结果:治疗组总有效率92.50%,明显高于对照组的77.50%,差异具有统计学意义(P<0.05);与对照组相比,治疗组GSH-PX含量升高、SOD活力增加、MDA、IL-6及TNF-α水平下降,差异均达到显著性水平(P<0.05);治疗组治疗后Scr、Upro、BUN含量降低(P<0.05);治疗组治疗后FPG、FINS、HbA1c及HOMA-IR均降低(P<0.05)。结论:本观察提示黄芪注射液可能通过降低炎性因子含量、提高抗氧化能力、改善胰岛素抵抗,从而对DKD(CKD3期)患者肾功能有一定的保护作用。

Objective:To explore the effects of astragalus injection on antioxidant capacity,insulin resistance and renal function in patients with DKD(CKD3).Methods:80 patients with DKD to stage 3 CKD admitted to internal medicine department and outpatient department of our hospital from May 2018 to May 2019 were selected and randomly divided into two groups,with 40 cases in each group.Control group was treated with conventional therapy,and treatment group was given astragalus injection on the basis of control group,and they were treated for 4 w.The clinical efficacy,and levels of serum GSH-PX,SOD,MDA,IL-6 and TNF-αwere observed in the two grou-ps before and after treatment.The levels of Scr,24h Upro and BUN were detected.The levels of venous FPG,FINS,HOMA-IR and HbA1c were measured before and after treatment.Results:The total effective rate of patients in the observation group was 92.50%,which was significantly higher than 77.50%in the control group,the difference was statistically significant(P<0.05).Compared with control group,the GSH-PX content was increased,and SOD activity was increased,and the levels of MDA,IL-6 and TN F-αwere decreased in treatment group(P<0.05).Compared with control group,the levels of Scr,Upro and BUN after treatment were decreased in treatment group(P<0.05).Compared with control group,the levels of FPG,FINS,HbA1c and HOM A-IR were reduced in treatment group(P<0.05).Conclusion:Astragalus injection can improve renal function in patients with DKD to stage 3 CKD by reducing the contents of infla mmatory factors,increasing SOD activity and reducing insulin resistance.