2型糖尿病肾病中医证型与TWEAK等炎症因子相关性试验研究

【目的】探讨糖尿病肾病(DN)患者不同中医证型与炎症因子之间的关系,为中医辨证分型、临床治疗、判断病情及预后提供依据。【方法】选择DN患者120例作为观察组,根据临床表现进行传统的中医辨证分型,应用酶联免疫吸附法(ELISA)对患者血尿标本进行检测,分析DN患者的中医证型与血、尿肿瘤坏死样凋亡微弱诱导因子(TWEAK)及血中白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)等炎症因子的相关性,并与30例健康体检者(健康组)作比较。【结果】(1)与健康组比较,DN无蛋白尿组、少量蛋白尿组、大量蛋白尿组、肾功能不全组等各期患者的血中TWEAK浓度均下降,尿TWEAK浓度及血中IL-1β浓度均上升(均P0.05);DN无蛋白尿组的血中IL-10浓度亦上升(P0.05)。(2)阴虚燥热证组血中TWEAK浓度明显高于其他组(P0.05),各主证血中TWEAK浓度依次为:阴虚燥热证气阴两虚证脾肾气虚证、阴阳两虚证;阴虚燥热证组尿中TWEAK浓度也明显高于其他组(P0.05),各主证尿中TWEAK浓度依次为:阴虚燥热证气阴两虚证脾肾气虚证阴阳两虚证;血中IL-1β水平,在所有证型中湿热证组表达最高(P0.05),阴虚燥热证组表达最低(P0.05);血中IL-10水平,在所有证型中阴虚燥热证组表达最高(P0.05),各主证血中IL-10水平依次为:阴虚燥热证气阴两虚证脾肾气虚证阴阳两虚证。【结论】DN中医辨证分型与TWEAK、IL-1β、IL-10等炎症因子有一定相关性,为临床治疗DN、判断病情及预后提供依据。

Relationship of Traditional Chinese Medical Syndromes of Type 2 Diabetic Nephropathy with Inflammatory Factors

Objective To explore the relationship between traditional Chinese medicine(TCM) syndrome types of diabetic nephropathy(DN) patients and inflammatory factors, thus to supply evidence for syndrome differentiation, clinical treatment, illness evaluation and prognosis of DN patients. Methods The study was carried out in 120 cases of DN patients, and the patients were differentiated into TCM syndromes according to the clinical manifestations. Blood and urine samples were detected with enzyme-linked immunosorbent assay (ELISA). The correlation of syndrome types with blood and urine tumour necrosis factor-like weak inducer of apoptosis (TWEAK), interleukin-1β(IL-1β) and IL-10 was analyzed, and the detection results were compared to 30 healthy volunteers. Results (1) Compared with the healthy control, abnormal blood and urine TWEAK content and abnormal blood IL-1β were shown in DN patients at the stages of non-albuminuria, small-amount albuminuria, large-amount albuminuria, and renal insufficiency(P<0.05); blood IL-10 content was increased in DN patients without albuminuria(P<0.05).(2) DN patients with yin-deficiency and dryness-heat had higher blood and urine TWEAK contents than DN patients with other syndrome types (P<0.05). The blood TWEAK content was in decreasing sequence in the syndrome types of yin-deficiency and dryness-heat, Qi-yin deficiency, spleen-kidney Qi deficiency, yin-yang deficiency; the urine TWEAK content was in decreasing sequence in the syndrome types of yin-deficiency and dryness-heat, Qi-yin deficiency, spleen-kidney Qi deficiency, yin-yang deficiency(P<0.05). DN patients with damp-heat syndrome had the highest blood IL-1βcontent (P < 0.05), and yin-deficiency and dryness-heat had the lowest IL-1β content (P < 0.05). DN patients with yin-deficiency and dryness-heat had higher blood IL-10 content (P<0.05), and the blood IL-10 content was in decreasing sequence in the syndrome types of yin-deficiency and dryness-heat, Qi-yin deficiency, spleen-kidney Qi deficiency, yin-yang deficiency. Conclusion TCM syndrome types of DN patients are correlated with TWEAK, IL-1β and IL-10, and the results will supply evidence for syndrome differentiation, clinical treatment, illness evaluation and prognosis of DN patients .