尿毒清颗粒辅助治疗糖尿病肾病的效果

Effect of Niaoduqing Granules adjuvant therapy on diabetic nephropathy

目的 观察尿毒清颗粒辅助治疗糖尿病肾病(DN)的效果。方法 选取成都医学院第二附属医院2021年3月至2022年12月收治的96例DN患者,按随机数字表法将其分为西医组(给予常规治疗及利格列汀)和中西医结合组(西医组基础上给予尿毒清颗粒治疗),各48例。评价两组临床疗效。比较两组治疗前后血糖指标[空腹血糖(FBG)、餐后2 h血糖(2h PBG)、糖化血红蛋白(HbA_(1c))],肾功能指标[血肌酐(Cr)、尿素氮(BUN)、肾小球滤过率(GFR)、24 h尿微量白蛋白、尿液中微量白蛋白与肌酐比值(UA/CR)水平],炎症因子[肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)、γ干扰素(IFN-γ)]和血清磷脂酰肌醇3激酶(PI3K)、Akt激酶和哺乳动物雷帕霉素靶蛋白(mTOR)水平。比较不良反应发生率。结果 中西医结合组临床疗效优于西医组,差异有统计学意义(P<0.05)。治疗后,两组FBG、2h PBG和HbA_(1c)较治疗前降低,且中西医结合组低于西医组,差异有统计学意义(P<0.05)。治疗后,两组Cr、BUN、24 h微量白蛋白尿和UA/CR水平较治疗前降低,GFR水平较治疗前升高,且中西医结合组Cr、BUN、24 h微量白蛋白尿和UA/CR水平低于西医组,GFR水平高于西医组,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、ICAM-1、IFN-γ、PI3K、Akt、mTOR水平均较治疗前降低,且中西医结合组低于西医组,差异有统计学意义(P<0.05)。两组不良发应总发生率比较,差异无统计学意义(P>0.05)。结论 尿毒清颗粒辅助治疗DN患者效果确切,能有效改善患者肾功能,减轻炎症反应和调节PI3K、Akt、mTOR水平,值得应用。

Objective To observe the effect of Niaoduqing Granules adjuvant therapy in the treatment of diabetic nephropathy(DN).Methods A total of 96 patients with DN admitted to the 2nd Affiliated Hospital of Chengdu Medical College from March 2021 to December 2022 were selected and they were divided into western medicine group(conventional treatment and linagliptin) and integration of traditional and western medicine group(Niaoduqing Granules on the basis of western medicine group) according to the random number table method,with 48 cases in each group.The clinical effect of the two groups was evaluated.Blood glucose indexes(fasting blood glucose [FBG],2 h postmeal blood glucose [2h PBG],glycosylated hemoglobin [HbA_(1c)]),renal function indexes(serum creatinine [Cr],urea nitrogen [BUN],glomerular filtration rate [GFR],24 h urinary microalbumin,urinary albumin creatinine ratio [UA/CR]) levels of inflammatory factors(tumor necrosis factor-α [TNF-α],intercellular adhesion molecule-1 [ICAM-1],interferon-γ [IFN-γ]),and serum phosphatidylinositol 3 kinase(PI3K),Akt kinase,and mammalian target of rapamycin(mTOR) of the two groups were compared before and after treatment.The incidence of adverse reactions was compared.Results The clinical effect of integration of traditional and western medicine group was better than that of western medicine group,and the difference was statistically significant(P<0.05).After treatment,FBG,2h PBG and HbA_(1c)in both groups were lower than before treatment,and the integration of traditional and western medicine group was lower than western medicine group,the differences were statistically significant(P<0.05).After treatment,Cr,BUN,24h microalbuminuria and UA/CR levels in two groups were lower than before treatment,and GFR levels were higher than before treatment,and Cr,BUN,24 h microalbuminuria and UA/CR levels in integration of traditional and western medicine group were lower than those in western medicine group,and GFR levels were higher than western medicine group,the differences were statistically significant(P<0.05).After treatment,levels of TNF-α,ICAM-1,IFN-γ,PI3K,Akt,and mTOR in both groups were lower than before treatment,and the integration of traditional and western medicine group was lower than the western medicine group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion Niaoduqing Granules adjuvant therapy has an exact efficacy in the treatment of patients with DN,and it can effectively improve the renal function,relieve the inflammatory response and regulate the levels of PI3K,Akt and mTOR.