雪莲益肾方联合西药治疗脾肾气虚型糖尿病肾病疗效及对氧化应激和足细胞损伤指标的影响

Efficacy of Xuelian Yishen Decoction and Western Medicine in Spleen and Kidney Qi Deficiency Type Diabetes Nephropathy and the Effects on Oxidative Stress and Podocyte Damage

目的:探讨雪莲益肾方联合西药治疗脾肾气虚型糖尿病肾病疗效及对氧化应激和足细胞损伤指标的影响。方法:收集92例脾肾气虚型糖尿病肾病患者分为对照组(n=46)和观察组(n=46)。对照组予西药治疗,观察组在对照组基础上联合雪莲益肾方治疗。比较疗效、24 h尿蛋白、24 h尿微量白蛋白、中医证候积分、氧化应激指标、足细胞损伤指标和不良反应。结果:观察组治疗总有效率高于对照组(93.5%vs 78.3%,P<0.05)。治疗后,观察组24 h尿蛋白、24 h尿微量白蛋白水平和中医证候积分低于对照组,氧化应激指标谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平高于对照组,丙二醛(MDA)水平低于对照组,足细胞损伤指标尿Nephrin和Podocin蛋白水平低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:雪莲益肾方联合西药治疗脾肾气虚型糖尿病肾病疗效确切,其机制可能与减轻氧化应激和足细胞损伤有关。

Objective:To investigate the efficacy of Xuelian yishen decoction and western medicine in spleen and kidney qi deficiency type diabetes nephropathy(SKQDDN)and the effects on oxidative stress and podocyte damage.Methods:92 SKQDDN patients were collected and divided into the control group(CG)and the observation group(OG)equally.CG was intervened with western medicine and OG was intervened with Xuelian yishen decoction additionally.The efficacy,24 h urine protein,24 h urine microalbumin,traditional Chinese medicine syndrome score(TCMSS),oxidative stress indices,podocyte damage and adverse reaction of the two groups were compared.Results:Total efficacy of OG was higher than that of CG(93.5%vs 78.3%,P<0.05).After treatment,levels of 24 h urinary protein,24 h urinary microalbumin,TCMSS,malondialdehyde(MDA),and podocyte damage indices of urinary nephrin and podocin protein in OG were lower than those in CG(P<0.05).Levels of oxidative stress indices of glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)in OG were higher than those in CG(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Xuelian yishen decoction combined with western medicine has obvious efficacy,which can improve symptoms and reduce urinary protein in SKQDDN patients.And the mechanism may be related to alleviating oxidative stress and podocyte damage.