芪术胶囊联合达格列净治疗老年早期糖尿病肾病对患者UAER、MCP-1水平的影响

Effect of Qizhu Capsules combined with dapagliflozin on the UAER and MCP-1 levels in elderly patients with early diabetic nephropathy

目的观察芪术胶囊联合达格列净治疗老年早期糖尿病肾病对患者24h尿微量白蛋白排泄率(UAER)、单核细胞趋化因子-1(MCP-1)水平的影响。方法选取老年早期糖尿病肾病患者130例,根据治疗方案的不同分为对照组与观察组,各65例。2组均给予常规治疗,对照组给予达格列净治疗,观察组给予芪术胶囊联合达格列净治疗。统计2组总有效率,记录2组肾功能指标、MCP-1、核因子-κB(NF-κB)、血管性血友病因子(vWF)、凝血酶调节蛋白(TM)、总胆固醇(TC)、三酰甘油(TG)、脂联素的变化。结果观察组有效率(90.77%,59/65)高于对照组(76.92%,50/65)(P<0.05)。与治疗前比较,2组UAER、血肌酐(SCr)、尿素氮(BUN)下降(P<0.05),观察组治疗后UAER、SCr、BUN低于对照组(P<0.05)。与治疗前比较,2组MCP-1、NF-κB、vWF、TM下降(P<0.05),观察组治疗后MCP-1、NF-κB、vWF、TM低于对照组(P<0.05)。与治疗前比较,2组TC、TG、脂联素下降(P<0.05),观察组治疗后TC、TG、脂联素低于对照组(P<0.05)。结论芪术胶囊联合达格列净治疗老年早期糖尿病肾病可通过抑制炎症反应,调节脂质代谢,减轻血管内皮损伤,改善肾功能,提高疗效。

Objective To observe the effect of Qizhu Capsules combined with dapagliflozin on the 24h urinary albumin excretion rate (UAER) and level of the monocyte chemotactic factor-1 (MCP-1) in the treatment of elderly patients with early diabetic nephropathy.Methods A total of 130 elderly patients with early diabetic nephropathy were selected and divided into a control group and an observation group according to the treatment plan,with 65 cases in each group.Both groups were given a routine treatment.In addition,the control group was given dapagliflozin,while the observation group was treated with Qizhu Capsules combined with dapagliflozin.The total effective rates of the two groups were counted,and the changes of the renal function indexes,levels of MCP-1,nuclear factor-κB (NF-κB),von Willebrand factor (vWF),thrombin regulatory protein (TM),total cholesterol (TC),triacylglycerol (TG) and adiponectin in both groups were recorded.Results The effective rate of the observation group (90.77%,59/65) was higher than that of the control group (76.92%,50/65) (P<0.05).Compared with before treatment,the levels of the UAER,serum creatinine (SCr) and blood urea nitrogen (BUN) in both groups were decreased (P<0.05),and the levels of the UAER,SCr and BUN in the observation group were lower than those in the control group (P<0.05).Compared with before treatment,the levels of the MCP-1,NF-κB,vWF and TM in both groups were decreased (P<0.05),and the levels of the MCP-1,NF-κB,vWF and TM in the observation group were lower than those in the control group (P<0.05).Compared with before treatment,the levels of the TC,TG and adiponectin in both groups were decreased (P<0.05),and the levels of the TC,TG and adiponectin in the observation group were lower than those in the control group (P<0.05).Conclusion Qizhu Capsules combined with dapagliflozin can improve the renal function and improve the curative effect in the treatment of senile early diabetic nephropathy by inhibiting the inflammatory response,regulating the lipid metabolism and reducing the vascular endothelial injury.