[目的]探讨健脾固肾化瘀方联合氯沙坦钾片治疗脾肾两虚夹瘀型糖尿病肾脏病(DKD)的临床疗效以及其对患者血清基质金属蛋白酶-9(MMP-9)、单核细胞趋化因子-1(MCP-1)和血管内皮生长因子(VEGF)水平的影响。[方法]选择沧州中西医结合医院2019...[目的]探讨健脾固肾化瘀方联合氯沙坦钾片治疗脾肾两虚夹瘀型糖尿病肾脏病(DKD)的临床疗效以及其对患者血清基质金属蛋白酶-9(MMP-9)、单核细胞趋化因子-1(MCP-1)和血管内皮生长因子(VEGF)水平的影响。[方法]选择沧州中西医结合医院2019年1月—2021年5月纳入80例脾肾两虚夹瘀型DKD患者作为研究对象,采用随机数字表法分成观察组与对照组各40例。观察组给予健脾固肾化瘀方联合氯沙坦钾片治疗,对照组单用氯沙坦钾片治疗,连续治疗12周后观察两组临床疗效。治疗前后检测受试者血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)]及肾功能指标[尿微量白蛋白/尿肌酐比值(UACR)、肌酐(SCr)和尿素氮(BUN)]。选用酶联免疫吸附法测定血清MMP-9、MCP-1和VEGF水平。并统计两组不良反应情况。[结果]观察组总有效率为92.50%(37/40),较对照组72.50%(29/40)有所提高(P<0.05)。两组治疗后FPG、2 h PG和HbA1c均较治疗前降低(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后血清TC、TG和LDL-C浓度均较治疗前下降(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后UAER和血清SCr、BUN水平均较治疗前降低(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后血清MMP-9水平均较治疗前升高(P<0.05),血清MCP-1、VEGF浓度均较治疗前下降(P<0.05);且治疗后,观察组对血清MMP-9水平的升高作用及对血清MCP-1、VEGF水平的降低作用较对照组更显著(P<0.01)。所有患者均无明显不良反应发生。[结论]应用健脾固肾化瘀方联合氯沙坦钾片治疗脾肾两虚夹瘀型DKD能安全有效地上调患者MMP-9表达水平,下调MCP-1、VEGF表达水平,改善肾功能,整体疗效确切。展开更多
慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)是一种以持续性气流受限为特征的可预防和治疗的疾病,气流受限呈进行性发展,其发病机制与氧化应激、炎症反应、自身免疫及蛋白酶–抗蛋白酶失衡有关。COPD常发生在中老...慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)是一种以持续性气流受限为特征的可预防和治疗的疾病,气流受限呈进行性发展,其发病机制与氧化应激、炎症反应、自身免疫及蛋白酶–抗蛋白酶失衡有关。COPD常发生在中老年人群,“培土生金”法是徐学义教授在诊疗COPD的过程中总结出来的经验法则,经过长期的临床及实验研究发现“培土生金 ”法能够治疗气道炎症性疾病,它对脾肾两虚型COPD患者具有较好的疗效。徐学义教授是贵州中医药大学第一附属医院国医堂主任医师,从事临床、教学工作40余年,他主张“五行生化”理论,认为“培土生金”法对COPD疾病的治疗具有独特作用,在临床中运用广泛,笔者有幸拜入徐学义教授门下,在跟师学习过程中感受颇深,本文基于“培土生金”理论,结合徐学义教授对肺系疾病的辨证施治及用药特点,初步探讨运用“培土生金”法治疗COPD的临床新用。Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation, and its pathogenesis is related to oxidative stress, inflammatory response, autoimmunity and protease-antiprotease imbalance. COPD often occurs in middle-aged and elderly people. “Reinforcing earth (spleen) to generate metal (lung)” method is a rule of thumb summed up by Professor Xu Xueyi in the process of diagnosing and treating COPD. After long-term clinical and experimental research, it is found that “reinforcing earth (spleen) to generate metal (lung)” method can treat airway inflammatory diseases, and it has a good effect on COPD patients with spleen and kidney deficiency. Professor Xu Xueyi is the chief physician of the First Affiliated Hospital of Guizhou University of Chinese Medicine. He has been engaged in clinical and teaching work for more than 40 years. He advocates the theory of “five elements of biochemistry” and believes that “reinforcing earth (spleen) to generate metal (lung)” method has a unique role in the treatment of COPD disease and is widely used in clinical practice. Based on the theory of “reinforcing earth (spleen) to generate metal (lung)”, combined with Professor Xu Xueyi’s syndrome differentiation and medication characteristics of pulmonary diseases, this paper discusses the new clinical application of “reinforcing earth (spleen) to generate metal (lung)” in the treatment of COPD.展开更多
文摘[目的]探讨健脾固肾化瘀方联合氯沙坦钾片治疗脾肾两虚夹瘀型糖尿病肾脏病(DKD)的临床疗效以及其对患者血清基质金属蛋白酶-9(MMP-9)、单核细胞趋化因子-1(MCP-1)和血管内皮生长因子(VEGF)水平的影响。[方法]选择沧州中西医结合医院2019年1月—2021年5月纳入80例脾肾两虚夹瘀型DKD患者作为研究对象,采用随机数字表法分成观察组与对照组各40例。观察组给予健脾固肾化瘀方联合氯沙坦钾片治疗,对照组单用氯沙坦钾片治疗,连续治疗12周后观察两组临床疗效。治疗前后检测受试者血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)]、血脂[总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)]及肾功能指标[尿微量白蛋白/尿肌酐比值(UACR)、肌酐(SCr)和尿素氮(BUN)]。选用酶联免疫吸附法测定血清MMP-9、MCP-1和VEGF水平。并统计两组不良反应情况。[结果]观察组总有效率为92.50%(37/40),较对照组72.50%(29/40)有所提高(P<0.05)。两组治疗后FPG、2 h PG和HbA1c均较治疗前降低(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后血清TC、TG和LDL-C浓度均较治疗前下降(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后UAER和血清SCr、BUN水平均较治疗前降低(P<0.05),且均以观察组的改善更显著(P<0.01)。两组治疗后血清MMP-9水平均较治疗前升高(P<0.05),血清MCP-1、VEGF浓度均较治疗前下降(P<0.05);且治疗后,观察组对血清MMP-9水平的升高作用及对血清MCP-1、VEGF水平的降低作用较对照组更显著(P<0.01)。所有患者均无明显不良反应发生。[结论]应用健脾固肾化瘀方联合氯沙坦钾片治疗脾肾两虚夹瘀型DKD能安全有效地上调患者MMP-9表达水平,下调MCP-1、VEGF表达水平,改善肾功能,整体疗效确切。
文摘慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)是一种以持续性气流受限为特征的可预防和治疗的疾病,气流受限呈进行性发展,其发病机制与氧化应激、炎症反应、自身免疫及蛋白酶–抗蛋白酶失衡有关。COPD常发生在中老年人群,“培土生金”法是徐学义教授在诊疗COPD的过程中总结出来的经验法则,经过长期的临床及实验研究发现“培土生金 ”法能够治疗气道炎症性疾病,它对脾肾两虚型COPD患者具有较好的疗效。徐学义教授是贵州中医药大学第一附属医院国医堂主任医师,从事临床、教学工作40余年,他主张“五行生化”理论,认为“培土生金”法对COPD疾病的治疗具有独特作用,在临床中运用广泛,笔者有幸拜入徐学义教授门下,在跟师学习过程中感受颇深,本文基于“培土生金”理论,结合徐学义教授对肺系疾病的辨证施治及用药特点,初步探讨运用“培土生金”法治疗COPD的临床新用。Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation, and its pathogenesis is related to oxidative stress, inflammatory response, autoimmunity and protease-antiprotease imbalance. COPD often occurs in middle-aged and elderly people. “Reinforcing earth (spleen) to generate metal (lung)” method is a rule of thumb summed up by Professor Xu Xueyi in the process of diagnosing and treating COPD. After long-term clinical and experimental research, it is found that “reinforcing earth (spleen) to generate metal (lung)” method can treat airway inflammatory diseases, and it has a good effect on COPD patients with spleen and kidney deficiency. Professor Xu Xueyi is the chief physician of the First Affiliated Hospital of Guizhou University of Chinese Medicine. He has been engaged in clinical and teaching work for more than 40 years. He advocates the theory of “five elements of biochemistry” and believes that “reinforcing earth (spleen) to generate metal (lung)” method has a unique role in the treatment of COPD disease and is widely used in clinical practice. Based on the theory of “reinforcing earth (spleen) to generate metal (lung)”, combined with Professor Xu Xueyi’s syndrome differentiation and medication characteristics of pulmonary diseases, this paper discusses the new clinical application of “reinforcing earth (spleen) to generate metal (lung)” in the treatment of COPD.
