真武汤治疗糖尿病肾病机制初步探讨

Mechanism of Zhenwu Decoction in Treating Diabetic Nephropathy

目的对真武汤治疗糖尿病肾病(DKD)的机制进行初步探讨。方法收集2018年1月-2019年12月盘锦市中医医院收治的诊断为非终末期DKD的患者80例,随机分为对照组和研究组各40例。两组均采用常规方案控制血糖,对照组加用氯沙坦控制血压:研究组在对照组基础上采用真武汤进行治疗,两组均治疗30 d。比较两组治疗后的临床指标和炎症、氧化应激指标。结果治疗后,研究组收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、24 h尿蛋白定量(24 hUTP)、尿素氮(BUN)、肌酐(Cr)水平均低于对照组,差异有统计学意义(P<0.05)。研究组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)、胱抑素C(Cys C)、转化因子(TGF-β)和丙二醛(MDA)水平低于对照组,而谷胱甘肽过氧化物酶(GSH-Px),超氧化物歧化酶(SOD)水平高于对照组,差异均有统计学意义(P<0.05)。结论在常规治疗基础上加用真武汤治疗DKD,可进--步改善患者的d糖.血压和肾功能指标,这可能与改善患者体内炎症状态和平衡氧化应激反应有关。

Objective To explore the mechanism of Zhenwu Decoction in the treatment of diabetic nephropathy(DKD).Methods A total of 80 patients diagnosed as non end-stage DKD in Panjin Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were olleted and randomly divided into control group and study group with 40 cases in each group.The two groups were treated with conventional regimen to control blood glucose.The control group was given losartan to control blood pressure,and the study group was treated with Zhenwu Decoction on the basis of the control group,both groups were treated for 30 days.The clinical indexes,inflammation and oxidative stress indexes were compared between the two groups.Results After treatment,SBP,DBP,FPG,2 hPG,HbAlc,24 h-UTP,BUN and Cr in the study group were significantly lower than those in the control group(P<0.05).The levels of CRP,IL-6,TNF-α,Cys C,TGF-β and MDA in the study group were significantly lower than those in the control group,while the levels of GSH-Px and SOD in the study group were significantly higher than those in the control group(P<0.05).Conclusion On the basis of conventional treatment,Zhenwu Decoction can further improve the blood glucose,blood pressure and renal function in DKD patients,which may be related to the improvement of inflarmmatory state and balance of oxidative stress reaction.