芪归药对干预气虚血瘀型糖尿病肾脏病患者血清8-iso-PGF2α的临床研究

Clinical Study of Huangqi(Astragalus)-Danggui(Angelica) on Intervention of Serum 8-iso-PGF2 in Diabetic Nephropathy Patients with Qi Deficiency and Blood Stasis

目的通过临床观察糖尿病肾脏病(DKD)患者血清中氧化应激指标血清8-iso-PGF2α水平,验证氧化应激与DKD的关系,探讨黄芪配伍当归对气虚血瘀型DKD患者的治疗作用,并找出达到最优治疗效果的芪归药对配伍比例。方法选取符合标准的糖尿病肾脏病患者36例,采用随机数字表法分为3组,即对照组、芪归5∶1组、芪归3∶2组,另外选取健康成年人12例组成空白组,选取单纯2型糖尿病(T2DM)患者12例组成单纯T2DM组。实验前测定TG、LDL、FBG、HbA1c、肝肾功能、mAlb、24 h尿蛋白、ROS、8-iso-PGF2α等指标。实验过程中,空白组不予任何治疗,单纯T2DM组与对照组维持其原有效治疗方案不变,芪归5∶1组与芪归3∶2组在原有效治疗方案基础上分别加用不同配比的黄芪与当归中药水煎液治疗,治疗90天后重新测定各项指标,比较治疗前后各指标变化情况。结果治疗前单纯T2DM组、对照组、芪归5∶1及3∶2组8-iso-PGF2α与其他相关指标水平明显高于空白组(P<0.05);对照组、芪归5∶1及芪归3∶2组8-iso-PGF2α与其他相关指标水平明显高于单纯T2DM组(P<0.05);治疗后芪归5∶1与3∶2组8-iso-PGF2α水平及其他相关指标较治疗前均有不同程度下降(P<0.05)。结论 DKD的发生与氧化应激密切相关;黄芪配伍当归通过降低DKD患者8-iso-PGF2α等氧化应激产物及相关临床指标的水平达到改善DKD的作用;黄芪当归配比3∶2时能更好改善DKD患者各项指标。

Objective To verify the relationship between oxidative stress and DKD by clinical observation of serum 8-iso-PGF2α level of oxidative stress index in DKD patients and explore the therapeutic effect of Huangqi(astragalus) compatibility with Danggui(angelica) on DKD patients with Qi deficiency and blood stasis,and find out the best proportion of Huangqi(astragalus)-Danggui(angelica).Methods A total of 36 patients with diabetic nephropathy were selected.According to the random number table method,the patients were divided into 3 groups,namely,the control group,the Huangqi(astragalus)-Danggui(angelica) 5∶1 group,the Huangqi(astragalus)-Danggui(angelica) 3∶2 group,In addition,12 healthy adults were as the blank group and 12 pure T2 DM patients were as the simple T2 DM group.Beforeexperiment,we measured levels of TG,LDL,FBG and HbA1 c,liver and kidney function,mAlb,24 hours urinary protein,ROS and 8-iso-PGF2α.At the experimental process,the blank group had no treatment.The pure T2 DM group and control group maintained its original effective treatment.Huangqi(astragalus)-Danggui(angelica) 5∶1 and 3∶2 groups were respectively treated with water decoction of Huangqi(astragalus) and Danggui(angelica) of different proportions on the basis of the original effective treatment plan.After 90 days of treatment,we determined the indexes again and compared the changes of each index before and after treatment.Results Before treatment,the levels of 8-iso-PGF2α and other related indicators in the pure T2 DM group,the control group,the Huangqi(astragalus)-Danggui(angelica) 5∶1 group and the Huangqi(astragalus)-Danggui(angelica) 3∶2 group were significantly higher than those of the blank group(P<0.05).The levels of 8-iso-PGF2α and other related indicators in the control group,the Huangqi(astragalus)-Danggui(angelica) 5∶1 group and the Huangqi(astragalus)-Danggui(angelica) 3∶2 groups were significantly higher than those of the pure T2 DM group(P<0.05).After treatment,the Huangqi(astragalus)-Danggui(angelica) 5∶1 and 3∶2 groups′ levels of 8-iso-PGF2α and other related indicators had different degrees of decrease(P<0.05).Conclusion The occurrence of DKD was closely related to oxidative stress.Huangqi(astragalus)-Danggui(angelica) can improve DKD by reducing the oxidative stress levels of 8-iso-PGF2αand the relevant clinical indicators of patients with DKD.The ratio of 3∶2 of Huangqi(astragalus)-Danggui(angelica) can better improve the indicators of DKD patients.