肾炎康复片治疗糖尿病肾病效果及其对患者肾间质炎症影响分析

Analysis of the therapeutic effect of Shenyan Kangfu tablets in the treatment of diabetic nephropathy and its effect on renal interstitial inflammation

目的探讨肾炎康复片治疗糖尿病肾病效果及其对患者肾间质炎症的影响。方法选取2017年3月至2018年12月在中国人民解放军联勤保障部队第962医院接受治疗的80例糖尿病肾病患者为研究对象,按随机数字表法将其分为对照组和试验组,每组各40例。对照组患者给予常规治疗,试验组患者给予常规治疗联合肾炎康复片治疗。对比两组患者治疗前后肾功能指标(血肌酐、24 h尿蛋白、血尿素氮、尿白蛋白排泄率和肾小球滤过率)、血清炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)和高敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)]水平和尿液中白介素-1β(interleukin-1β,IL-1β)、白介素-18(interleukin-18,IL-18)水平。观察糖尿病肾病患者肾间质炎症与TNF-α、IL-6、hs-CRP、IL-1β、IL-18表达的相关性。结果试验组患者治疗总有效率显著高于对照组(P<0.05)。治疗后,两组患者血肌酐、24 h尿蛋白、血尿素氮、TNF-α、IL-6、hs-CRP、IL-1β、IL-18水平和尿白蛋白排泄率、肾间质炎性细胞浸润百分比均显著低于本组治疗前(均P<0.05);试验组患者治疗后血肌酐、24 h尿蛋白、血尿素氮、TNF-α、IL-6、hs-CRP、IL-1β、IL-18水平和尿白蛋白排泄率、肾间质炎性细胞浸润百分比均显著低于同期对照组(均P<0.05)。糖尿病肾病患者肾间质炎症与TNF-α、IL-6、hs-CRP、IL-1β和IL-18表达均呈正相关(r=0.881、0.725、0.847、0.910、0.621,均P<0.05)。两组患者治疗后主要并发症发生率比较差异均无统计学意义(均P>0.05)。结论肾炎康复片能降低糖尿病肾病患者炎性因子水平,改善肾功能,提高患者生活质量。

Objective To investigate the therapeutic effect of Shenyan Kangfu tablets in the treatment of diabetic nephropathy and its effects on renal interstitial inflammation.Method Eighty patients with diabetic nephropathy who were treated in the 962th Hospital of Joint Logistic Support Force of PLA from March 2017 to December 2018 were selected as the research objects.They were divided into control group and experimental group according to random number table method,40 cases in each group.Patients in control group were given conventional treatment,and patients in experimental group were given conventional treatment combined with Shenyan Kangfu tablets.The renal function indexes(serum creatinine,24-hour urine protein,blood urea nitrogen,urine albumin excretion rate,glomerular filtration rate),serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and highsensitivity C reactive protein(hs-CRP)],and interleukin-1β(IL-1β),interleukin-18(IL-18)levels were compared between the two groups before and after treatment.To observe the correlation between renal interstitial inflammation and the expression of TNF-α,IL-6,hs-CRP,IL-1β,and IL-18 in patients with diabetic nephropathy.Result The total effective rate in experimental group was significantly higher than that in control group(P<0.05).After treatment,the blood creatinine,24-hour urine protein,urea nitrogen,TNF-α,IL-6,hs-CRP,IL-1βand IL-18 levels,urine albumin excretion rate and the percentage of inflammatory cell infiltration in renal interstitium,in the two groups were significantly lower than those before treatment(all P<0.05),while the blood creatinine,24-hour urine protein,urea nitrogen,TNF-α,IL-6,hs-CRP,IL-1βand IL-18 levels,urine albumin excretion rate and the percentage of inflammatory cell infiltration in renal interstitiumin experimental group were significantly lower than those in control group(all P<0.05).Renal interstitial inflammation in patients with diabetic nephropathy were positively correlated with the expression of TNF-α,IL-6,hs-CRP,IL-1βand IL-18(r=0.881,0.725,0.847,0.910,0.621,all P<0.05).The incidence of major complications between the two groups of patients was not statistically significant(all P>0.05).Conclusion Shenyan Kangfu tablets can reduce the expression of inflammatory factors in patients with diabetic nephropathy,improve renal function,and improve the quality of life of patients.