益肾化湿颗粒对糖尿病肾病患者临床参数及血清缺氧诱导因子-1α的影响

Effect of Yishen Huashi Granule on clinical parameters and HIF-1α in patients with diabetic nephropathy

目的探讨益肾化湿颗粒对2型糖尿病肾病患者临床参数及血清缺氧诱导因子-1α(HIF-1α)的影响。方法选取2020年11月至2021年12月秦皇岛市第一医院肾内科门诊及住院收治的2型糖尿病肾病患者60例。将2型糖尿病肾病患者按随机数字表法分配至益肾化湿颗粒组(试验组30例,1袋/次,每日3次,口服)或未使用益肾化湿颗粒组(对照组30例),随访12周,试验组及对照组血糖(空腹血糖、糖化血红蛋白)、血脂(总胆固醇、三酰甘油、低密度脂蛋白胆固醇)、肾功能(肌酐、尿素氮、尿酸、β_(2)-微球蛋白)、尿白蛋白排泄率、血清缺氧诱导因子-1α水平变化。结果治疗后,试验组和对照组的肌酐[(102±34)μmol/L与(162±148)μmol/L]、β_(2)微球蛋白[(4.9±2.1)mg/L与(7.5±5.4)mg/L]、肾小球滤过率[(74±26)ml·min^(-1)·1.73 m^(-2)与(59±34)ml·min^(-1)·1.73 m^(-2)]比较,试验组下降,差异有统计学意义(t=-2.81,-2.43,3.12,P均<0.05)。试验组的中医证候疗效有效率为77%,而对照组40%,差异有统计学意义(χ^(2)=8.297,P=0.004)。试验组与对照组临床综合疗效分析有效率分别为77%和37%,差异具有统计学意义(χ^(2)=9.77,P=0.002)。结论益肾化湿颗粒可有效延缓糖尿病肾病患者肾功能的进展。目前尚未得出益肾化湿颗粒能通过抑制HIF-1α对糖尿病肾病患者的发挥肾脏保护作用的结论。

Objective To explore the effects of Yishen Huashi Granule on clinical parameters and serum hypoxia inducible factor-1α(HIF-1α)in patients with type 2 diabetic nephropathy.Methods From November 2020 to December 2021,sixty patients with diabetic nephropathy(30 cases in experimental group and 30 cases in control group)were selected.Patients with type 2 diabetic nephropathy were assigned to the oral Yishen Huashi Granule group three times a day(experimental group)or the non-Yishen Huashi Granule group(control group),fol-lowed up for 12 weeks.The blood glucose(fasting blood glucose,glycosylated hemoglobin),blood lipid(choles-terol,triglyceride,low density lipoprotein),kidney function(creatinine,urea nitrogen,uric acid,β_(2)-microglobulin),and UAER,HIF-1α of the experimental group and the non-experimental group were calculated and compared.Results After treatment,the creatinine[(102±34)μmol/L vs(162±148)μmol/L]andβ_(2) microglobulin[(4.9±2.1)mg/L vs(7.5±5.4)mg/L]and eGFR[(74±26)ml·min^(-1)·1.73 m^(-2) vs(59±34)ml·min^(-1)·1.73 m^(-2)]in the experimental group were lower than those in the non-experimental group,and the differences between two groups were statistically significant(t=-2.81,-2.43,3.12,all P<0.05).The effective rate of TCM syndromes in the experimental group was 77%,while that in the non-experimental group was 40%,the χ^(2) test showed statistical significance(χ^(2)=8.297,P=0.004).The effective rates of clinical comprehensive curative effect analysis of experimental group and non-ex-perimental group were 77% and 37%,respectively,which were statistically significant by χ^(2) test(χ^(2)=9.77,P=0.002).Conclusion Yishen Huashi Granule can effectively delay the progress of renal function in patients with diabetic nephropathy.At present,it has not been concluded that Yishen Huashi Granule can exert renal protective effect on diabetic nephropathy patients by inhibiting HIF-1α.