活血益肾方联合前列地尔对糖尿病肾病肾功能、炎症因子及血液流变学的影响

Effects of Huoxue Yishen Decoction(活血益肾方)and Alprostadil on Renal Function,Inflammatory Factor and Hemorheology in Patients with Diabetic Nephropathy

目的探讨前列地尔联合活血益肾方对早期糖尿病肾病患者肾功能、炎症因子及血液流变学的影响,为临床治疗策略的选择提供理论依据。方法选取172例早期糖尿病肾病患者,随机分为观察组和对照组,每组86例。对照组静脉推注前列地尔,观察组加服活血益肾方。比较两组患者治疗前后的尿微量白蛋白、尿白蛋白排泄率(UAER)以及肾功能指标、炎症因子和血液流变学指标的检测结果。结果两组患者治疗后的尿微量白蛋白、UAER、尿素氮(BUN)、肌酐(SCr)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、全血低切黏度(LBV)、全血高切黏度(HBV)、血浆黏度(PV)、纤维蛋白原(PF)均显著低于治疗前(P<0.05)。观察组治疗后的尿微量白蛋白为(21.39±3.03)ng/g·Cr,UAER为(65.89±10.91)mg/24h,BUN为(5.03±1.43)mmol/L,SCr为(85.18±17.09)μmol/L,TNF-α为(1.09±0.39)ng/L,IL-6为(72.08±25.69)ng/L,IL-8为(31.41±9.78)ng/L,LBV为(7.49±3.43)mPa·s,HBV为(4.09±0.73)mPa·s,PV为(1.28±0.26)mPa·s,PF为(3.17±0.43)g/L,均显著低于对照组(P<0.05)。结论前列地尔联合活血益肾方可改善早期糖尿病肾病患者的肾功能,减轻蛋白尿,抑制炎症反应,改善血流动力学,提高临床治疗效果。

Objective To explore the effects of alprostadil combined with Huoxue Yishen Recipe(活血益肾方)on renal function,inflammatory factors and hemorheology in patients with early diabetic nephropathy and provide theoretical basis for the choice of clinical treatment strategies.Methods A total of 172 patients with early diabetic nephropathy were randomly divided into observation group and control group,86 cases in each group.The control group was given alprostadil intravenously,while the observation group was given Huoxue Yishen Recipe.The results of urinary microalbumin,urinary albumin excretion rate(UAER),renal function index,inflammatory factor and hemorheological index were compared between the two groups before and after treatment.Results After treatment,urinary microalbumin,UAER,BUN,creatinine(SCr),tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),whole blood low shear viscosity(LBV),whole blood high shear viscosity(HBV),plasma viscosity(PV)and fibrinogen(PF)were detected in both groups.They were significantly lower than those before treatment(P<0.05).After treatment,urine microalbumin was(21.39±3.03)ng/g·Cr,UAER was(65.89±10.91)mg/24 h,UAER was(65.89±10.91)mg/24 h,BUN was(5.03±1.43)mmol/L,BUN was(5.03±1.43)mmol/L,SCr was(85.18±17.09)mmol/L,TNF-alpha was(1.09±0.39)ng/L,IL-6 was(72.08±25.69)ng·L^(-1)and IL-8 was(31.41±9.78)ng·L^(-1),which were significantly lower than those of the control group(P<0.05).Conclusion Alprostadil combined with Huoxue Yishen Recipe can improve renal function,alleviate proteinuria,inhibit inflammatory reaction and improve hemodynamics clinical therapeutic effect in patients with early diabetic nephropathy.