补气益肾活血方联合缬沙坦对糖尿病肾病患者临床研究

Clinical study of Yishenbuxue Decoction combined with valsartan on the treatment of diabetic nephropathy

目的:观察益肾补血方联合缬沙坦对糖尿病肾病患者的疗效并探究其可能的机制。方法:本研究共纳入60例糖尿病肾病患者,按照随机数字表法将其随机分为治疗组与对照组各30例。两组患者均给予降糖、降压、控制饮食、适量运动等基础治疗;同时对照组口服缬沙坦分散片80 mg/次,1次/d;治疗组在对照组基础上口服补气益肾活血方,1剂/d,2次/d。两组疗程均为3个月。疗程结束后,比较两组患者治疗疗效,治疗前后24 h尿蛋白定量、胱抑素C(CysC)和血红素氧合酶-1(HO-1)及肾功能[尿素蛋(BUN)和肌酐(Cr)]变化。结果:治疗后,治疗组的有效率(70.00%)显著优于对照组(43.33%)(P<0.05)。治疗前,两组的24 h尿蛋白定量、CysC、HO-1、BUN和Cr比较差异无统计学意义(P>0.05);治疗后,两组的24 h尿蛋白定量、CysC、HO-1、BUN和Cr较治疗前显著改善(P<0.05);治疗组显著优于对照组(P<0.05)。结论:补气益肾活血方可能通过Cys C和HO-1表达显著减少糖尿病肾病患者的尿蛋白,改善肾脏功能,具有重要临床应用价值。

Objective:To observe the effect of Yishen Buxue Decoction combined with valsartan on diabetic nephropathy and explore its possible mechanism.Methods:A total of 60 patients with diabetic nephropathy were randomly divided into treatment group and control group,with 30 cases in each group.Patients in both groups were given basic treatment such as hypoglycemic,antihypertensive,diet control,moderate exercise,and other basic treatment.Meanwhile,the control group received valsartan dispersible tablets 80 mg/time,once a day.On the basis of the control group,the treatment group was given Yishen Buxue decoction orally,one dose per day,twice a day,and the treatment period were three months.After the course of treatment,the therapeutic effect,urinary protein level,cystatin C(CysC),heme oxygenase-1(HO-1),renal function[BUN and creatinine(Cr)]before and after 24 hours of treatment were compared between the two groups.Results:After treatment,the effective rate of the treatment group was significantly better than that of the control group(70.00%vs 43.33%)(P<0.05).Before treatment,there was no significant difference in 24-hour urinary protein level,CysC,HO-1,BUN,and Cr between the two groups(P>0.05).After treatment,the 24-hour urinary protein level,CysC,HO-1,BUN,and Cr in the two groups were significantly improved compared with before treatment(P<0.05).The treatment group was significantly better than the control group(P<0.05).Conclusion:Buqi Yishen Huoxue decoction can dramatically reduce urinary protein and improve renal function in patients with diabetic nephropathy by inducing lower expression of CysC and HO-1,which has significant clinical application value.