[1]朱德礼,张 宇,张元丽,等.参麦地黄汤联合坎地沙坦酯治疗早期糖尿病肾病疗效及对患者血清转化生长因子-β1、单核细胞趋化蛋白-1的影响[J].陕西中医,2023,(2):209-212.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.016]
　ZHU Deli,ZHANG Yu,ZHANG Yuanli,et al.Effect of Shenmai Dihuang decoction plus candesartan on early diabetic nephropathy and effect of serum transforming growth factor-β1 and monocyte chemoattractant protein-1[J].,2023,(2):209-212.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.016]
点击复制

参麦地黄汤联合坎地沙坦酯治疗早期糖尿病肾病疗效及对患者血清转化生长因子-β1、单核细胞趋化蛋白-1的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
209-212
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Effect of Shenmai Dihuang decoction plus candesartan on early diabetic nephropathy and effect of serum transforming growth factor-β1 and monocyte chemoattractant protein-1
作者:
朱德礼; 张 宇; 张元丽; 林子程
(三亚市中医院肾病科,海南 三亚 572022)
Author(s):
ZHU Deli; ZHANG Yu; ZHANG Yuanli; LIN Zicheng
(Nephrology Department of Sanya Traditional Chinese Medicine Hospital,Sanya 572022,China)
关键词:
糖尿病肾病;  坎地沙坦酯;  参麦地黄汤;  转化生长因子-β1;  单核细胞趋化蛋白-1
Keywords:
Diabetic nephropathy;  Candesartan cilexetil;  Shenmai Dihuang decoction;  Transforming growth factor-β1;  Monocyte chemoattractant protein-1
分类号:
R 587.2
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.016
文献标志码:
A
摘要:
目的:探讨参麦地黄汤联合坎地沙坦酯对早期糖尿病肾病的疗效及对患者血清转化生长因子-β1(TGF-β1)、单核细胞趋化蛋白-1(MCP-1)的影响。方法:选择接受治疗的86例早期糖尿病肾病患者,以随机数字表法分成对照组与观察组,各43例。对照组接受坎地沙坦酯治疗,观察组在对照组的基础上接受参麦地黄汤治疗,两组治疗时间均为8周。对比两组中医症候积分、尿蛋白排泄率(UAER)、血肌酐(Scr)、血尿素氮(BUN)、血管内皮生长因子(VEGF)、TGF-β1、细胞间黏附分子-1(ICAM-1)、单核细胞趋化蛋白-1(MCP-1)、不良反应及临床疗效。结果:治疗后两组的中医症候积分均降低,且观察组更低(P<0.05); 治疗后两组UAER、Scr、BUN水平均比治疗前低,且观察组比对照组低(P<0.05); 治疗后两组VEGF、TGF-β1水平均比治疗前低,且观察组比对照组低(P<0.05); 治疗后两组VEGF、TGF-β1水平均降低,且观察组更低(P<0.05); 治疗后两组ICAM-1、MCP-1水平均降低,且观察组更低(P<0.05); 两组不良反应发生率比较差异无统计学意义(P>0.05); 观察组总有效率比对照组高(P<0.05)。结论:坎地沙坦酯联合参麦地黄汤可改善早期糖尿病肾病微炎症状态、临床症状以及肾功能,疗效确切,降低血清TGF-β1、MCP-1水平。
Abstract:
Objective:To investigate the curative effect of Shenmai Dihuang decoction combined with candesartan cilexetil on early diabetic nephropathy and the expression of serum transforming growth factor-β1(TGF-β1)and monocyte chemoattractant protein-1(MCP-1).Methods:A total of 86 patients with early diabetic nephropathy were randomly divided into control group(n=43,treated with candesartan)and observation group(n=43,treated with Shenmai Dihuang decoction plus or minus on the basis of control group).The treatment time of both groups was 8 weeks.TCM symptom score,urinary protein excretion rate(UAER),serum creatinine(Scr),blood urea nitrogen(BUN),vascular endothelial growth factor(VEGF),TGF-β1,intercellular adhesion molecule-1(ICAM-1),monocyte chemoattractant protein-1(MCP-1),adverse reactions and clinical efficacy were compared between the two groups.Results:After treatment,two groups of TCM symptom scores were decreased,while observation group was lower(P<0.05).After treatment,the levels of UAER,Scr and BUN in two groups were lower than before treatment,and the observation group was lower than control group(P<0.05).After treatment,the levels of VEGF and TGF-β1 in both groups were lower than before treatment,and the observation group was lower than control group(P<0.05).After treatment,ICAM-1 and MCP-1 levels in the two groups were decreased,and the observation group was lower(P<0.05).There was no difference in the total incidence of adverse reactions between the two groups(P>0.05).The observation group of total effective rate was higher than control group(P<0.05).Conclusion:Candesartan ester combined with Shenmai Dihuang decoction can improve the microinflammatory state,clinical symptoms and renal function of early diabetic nephropathy,with definite effect,and reduce the serum levels of TGF-β1 and MCP-1.

参考文献/References:

[1] 刘海波,许建秦,李春梦,等.胱抑素C和甘油三酯检测对糖尿病肾病的早期诊断价值研究[J].陕西医学杂志,2021,50(1):96-99.
[2] Opazo RL,Mas S,Marin RG,et al.Lipotoxicity and diabetic nephropathy:Novel mechanistic insights and therapeutic opportunities[J].Int J Mol Sci,2020,21(7):2632.
[3] 方锦颖,王一冲,神原优滋,等.基于网络药理学和分子对接探究肾康注射液治疗糖尿病肾病作用机制[J].陕西中医,2021,42(12):1798-1802.
[4] 王西安,陈海英,叶盛开,等.西洛他唑联合坎地沙坦酯分散片治疗早期糖尿病肾病的疗效观察[J].中华保健医学杂志,2018,20(6):498-501.
[5] 代广玉,修丽梅.糖尿病肾病中医辨证分型研究进展[J].陕西中医,2021,42(1):131-133.
[6] 刘怀智,周海娟,陈 刚,等.参麦地黄汤联合常规治疗对气阴两虚证早期糖尿病肾病患者的临床疗效[J].中成药,2021,43(7):1759-1763.
[7] Kim S,Kang SW,Joo J,et al.Characterization of ferroptosis in kidney tubular cell death under diabetic conditions[J].Cell Death Dis,2021,12(2):160.
[8] Raina P,Sikka R,Gupta H,et al.Association of eNOS and MCP-1 genetic variants with type 2 diabetes and diabetic nephropathy susceptibility:A case-control and meta-analysis study[J].Biochem Genet,2021,59(4):966-996.
[9] 中华医学会糖尿病学分会微血管并发症学组.中国糖尿病肾脏病防治指南(2021年版)[J].中华糖尿病杂志,2021,13(8):762-784.
[10] 中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版,2002:77-85.
[11] 中华中医药学会肾病分会.糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案)[J].上海中医药杂志,2007,41(7):7-8.
[12] 薛海燕,李振江,孔令强.不同分期糖尿病肾病患者25羟维生素D、低氧诱导因子-1α检测及临床意义[J].陕西医学杂志,2021,50(5):614-617.
[13] 张 宇,李建平,张元丽.真武汤加减联合氯沙坦钾片治疗老年早中期糖尿病肾病临床疗效及对TLR4/MyD88通路的影响[J].中国老年学杂志,2022,42(7):1687-1690.
[14] 刘 芳,张立祥,王慧敏,等.养生益肾汤对糖尿病肾病患者血清细胞因子水平及肾功能的影响[J].陕西中医,2022,43(4):476-478,486.
[15] 张 良,王 丹,金艳红,等.加味参芪地黄汤干预内质网应激辅助治疗糖尿病肾病的疗效及对肾功能、糖脂代谢的影响[J].中国现代医学杂志,2022,32(10):47-52.
[16] 王 露,李 见.2型糖尿病肾病患者血清NF-κB、MDA水平及其与肾功能的关系探讨[J].中国现代医学杂志,2022,32(3):21-25.
[17] 高子涵,李瑞芳,吕行直,等.山药多糖对糖尿病肾病小鼠肾功能和醛糖还原酶通路的影响[J].中药材,2019,42(3):643-646.
[18] 汪 景,位佳琳,何 蕊,等.网络药理学方法预测附子-熟地黄配伍治疗COPD作用机制以及初步验证研究[J].中国免疫学杂志,2022,38(4):419-426.
[19] 王 华.参麦地黄汤联合达格列净对气阴亏虚型早期糖尿病肾病患者血糖及尿微量白蛋白的影响——附49例临床资料[J].江苏中医药,2022,54(4):44-46.
[20] 黄 勇,程 洁,周晔华,等.肾苏Ⅳ对糖尿病肾病大鼠足细胞、podocin及VEGF水平的影响[J].中国老年学杂志,2021,41(15):3280-3285.
[21] 郭文荣,李 兴.糖尿病肾病与ADPN、TGF-β1、Collagen Ⅳ、ICAM-1关系的研究进展[J].医学研究杂志,2015,44(6):170-173.
[22] 陈 丹,胡韬韬,张 妙.海昆肾喜胶囊联合缬沙坦对老年早期糖尿病肾病患者细胞因子、TGF-β1、MMP-2和肾功能的影响[J].中国老年学杂志,2022,42(7):1673-1676.

相似文献/References:

[1]张华贞.复方黄芪汤加减联合骨化三醇治疗糖尿病肾病疗效及对患者血糖、肾功的影响*[J].陕西中医,2019,(6):767.
[2]程红卫,成晓萍.阎晓萍从脾论治糖尿病肾病经验总结*[J].陕西中医,2019,(6):790.
[3]黄聪丽,王治新△.益气滋肾活血通络方治疗早中期糖尿病肾病临床研究[J].陕西中医,2019,(10):1390.
　HUANG Congli,WANG Zhixin..Clinical efficacy analysis of Yiqi Zishen Huoxue Tongluo decoctionon early and medium stage of diabetic nephropathy[J].,2019,(2):1390.
[4]玉山江·艾克木,哈丽达·木沙△,地丽尼嘎尔.西红康联合还原型谷胱甘肽治疗2型糖尿病肾病Ⅲ期气阴两虚夹瘀证疗效及对患者微炎症状态、抗氧化的影响*[J].陕西中医,2020,(3):338.
　Yushanjiang·Aikemu,Halida·Musha,Dilinigaer..Efficacy of adjuvant therapy of Xihongkang on type 2 diabetic nephropathy Ⅲ phase with syndrome of Qiyin Liangxu Jiayu type and its effect on micro inflammation and antioxidant role[J].,2020,(2):338.
[5]马民凯,马红建,陈新苗.通络散结汤对3期糖尿病肾病患者GFR、UAER、β2-MG、Cys-C及微炎症状态的影响*[J].陕西中医,2020,(10):1432.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.025]
[6]田娟娟,陈 强,周欣欣,等.益气养阴活血法治疗糖尿病肾病理论探究*[J].陕西中医,2020,(12):1781.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.026]
[7]代广玉,修丽梅.糖尿病肾病中医辨证分型研究进展[J].陕西中医,2021,(1):131.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.036]
[8]赵 亚,张勉之,樊威伟,等.国医大师张大宁治疗糖尿病肾病用药经验[J].陕西中医,2021,(6):773.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.025]
[9]张 蕊,王子承,蒋荣莉,等.防己黄芪汤加味治疗糖尿病肾病疗效及对患者糖脂代谢、氧化应激的影响[J].陕西中医,2021,(8):1049.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.015]
　ZHANG Rui,WANG Zicheng,JIANG Rongli,et al.Effect of Fangji Huangqi decoction on diabetic nephropathy and its influence on glucose and lipid metabolism and oxidative stress[J].,2021,(2):1049.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.015]
[10]方锦颖,王一冲,神原优滋(日本),等.基于网络药理学和分子对接探究肾康注射液治疗糖尿病肾病作用机制[J].陕西中医,2021,(12):1798.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.039]

备注/Memo

备注/Memo:
基金项目:海南省卫生健康行业科研项目(20A200199)
更新日期/Last Update: 2023-02-08