固元汤对糖尿病肾病微循环障碍的影响

观察固元汤对糖尿病肾病微循环障碍的影响。方法:选取2015年7月1日至2016年10月1日间就诊的60例2型糖尿病患者,随机分为观察组和对照组,每组30例。对照组口服依那普利(1片/d)和皮下注射胰岛素(诺和灵30 R)1.0 IU/kg;观察组在此基础上加用固元汤。疗程为6周。治疗前后测空腹血糖、尿蛋白排泄率(UAER);血尿素氮(BUN)、肌酐(Scr)、肾小球滤过率(GFR);全血黏度和血小板源生长因子(PDGF)的水平。结果:2组治疗后空腹血糖和UAER均低于治疗前(P0.05);与对照组比较,观察组治疗后空腹血糖和UAER下降幅度较多(P0.05)。2组患者治疗后BUN和Scr均降低(P0.05),GFR升高(P0.05);观察组优于对照组(P0.05)。固元汤能降低全血黏度和下调PDGF表达水平,且抑制程度高于对照组(P0.05)。结论:固元汤可以改善糖尿病肾病患者微循环状态。

Guyuan Decoction on Microcirculation Disorder of Diabetic Nephropathy

To observe the effect of Guyuan Decoction on microcirculation disturbance of diabetic nephropathy.Methods:Sixty cases of type 2 diabetes were randomly divided into an observation group and a control group,who came to our department from July 1st,2015 to October 1st,2016,each group of 30 cases.The control group was treated with 1 tablet of enalapril per day and subcutaneous injection of insulin (Novolin R 30) 1 international units per kg; the observation group with extra use of Guyuan decoction.The duration was 6 weeks.Fasting blood glucose,urine protein excretion rate (UAER),blood urea nitrogen (BUN),creatinine (Scr),glomerular filtration rate (GFR),whole blood viscosity and platelet derived growth factor (PDGF) levels were tested before and after treatment.Results:After the treatment,fasting blood glucose and UAER level of the two groups were lower than those before treatment (P<0.05); comparing with the control group,after treatment,fasting blood glucose and UAER of the observation group decreased significantly (P<0.05).After treatment,BUN and Scr of the two groups of patients were decreased (P<0.05),GFR increased (P<0.05); the observation group was better (P<0.05).The decoction can reduce the whole blood viscosity and down regulate the expression level of PDGF,and the inhibition degree of the treatment group was higher than that of the control group (P<0.05).Conclusion:The Guyuan Decoction can improve microcirculation of diabetic patients with diabetic nephropathy,which may be one of the possible mechanisms of the therapeutic effect.