培元通络方对糖尿病肾脏病临床疗效及微炎症状态的影响

目的观察培元通络方对糖尿病肾脏病(DKD)IV期临床疗效及微炎症状态的影响,探讨培元通络方治疗DKD的作用机制。方法采用SAS软件随机程序,将106例DKD-IV期患者分为治疗组(培元通络方颗粒组)和对照组(尿毒清颗粒组),每组53例,实际完成98例,治疗组和对照组各49例。2组患者除基础治疗外,治疗组予培元通络方颗粒,对照组予尿毒清颗粒,疗程均为8周。观察2组患者治疗前后的中医证候疗效、血肌酐(SCr)、肾小球滤过率(e GFR)、24 h尿蛋白定量(24 h U-pro)、微量尿蛋白(U-Alb)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的变化情况,并进行统计分析。结果与本组治疗前比较,治疗后治疗组各项中医证候明显减轻(P0.05或P0.01),优于对照组同期(P0.05或P0.01)。与本组治疗前比较,治疗后治疗组SCr、24 h U-pro及U-Alb水平明显下降(P0.01),e GFR水平上升(P0.05),且优于对照组同期(P0.05或P0.01)。与本组治疗前比较,治疗后治疗组hs-CRP、TNF-α、IL-6水平均明显降低(P0.01),且优于对照组同期(P0.05)。治疗组临床疗效总有效率73.47%,优于对照组的44.90%,差异有统计学意义(P0.05)。2组患者均未出现明显不良反应情况。结论培元通络方结合西医基础治疗能有效降低DKD-IV期患者尿蛋白,保护肾脏,改善微炎症状态。

Influence of Peiyuan Tongluo Fang on clinical efficacy and micro-inflam-mation state in patients with diabetic kidney disease

Objective To observe the influence of Peiyuan Tongluo Fang(Qi-tonifying Collateral-dred-ging Decoction,PTF)on clinical efficacy and micro-inflammation state in patients with phase IV diabetic kidney disease(DKD),and investigate the mechanism of PTF in treatment of DKD.Methods Phase IV DKD patients(n=106)were randomly divided into treatment group and control group(each n=53).There were actually 98 patients had complete treatment in 2 groups(each n=49).Besides of basic therapy,the treatment group was treated with PTF,and control group was treated with Niaoduqing Gran-ule for 8 weeks.The changes of TCM patterns and levels of serum creatinine(SCr),estimated glomeru-lar filtration rate(eGFR),24 h urinary protein excretion(24 h U-pro), urinary microalbumin protein (U-Alb),high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleu-kin-6(IL-6)were observed and analyzed statistically in two groups.Results After treatment,all TCM patterns were significantly relieved(P<0.05 or P<0.01)in treatment group compared with before, which were superior to those in control group(P<0.05 or P<0.01).After treatment,levels of SCr,24 h U-pro and U-Alb decreased significantly(P<0.01)and eGFR level increased(P<0.05)in treat-ment group compared with before treatment,which were superior to those in control group(P<0.05 or P<0.01).After treatment, levels of hs-CRP, TNF-αand IL-6 decreased significantly(P <0.01)in treatment group compared with before treatment, which were superior to those in control group(P <0.05).The total effective rate was 73.47%(36/49)in treatment group,and 44.90%(22/49)in con-trol group(P<0.05).No adverse reactions were observed in 2 groups.Conclusion PTF combined with basic therapy of Western medicine can effectively reduce urine protein,protect kidney and alleviate micro-inflammation state in patients with phase IV DKD.