芪归药对对气虚血瘀型早期糖尿病肾病患者血清NO和NOS的影响

目的:观察早期糖尿病肾病(DN)患者血清一氧化氮(NO)和一氧化氮合酶(NOS)水平,探讨黄芪与当归不同配伍比例治疗早期DN的作用机制,确定最佳量效关系。方法:选取气虚血瘀型DN患者42例,随机分为7组,包括对照组、小剂量芪归5∶1组、大剂量芪归5∶1组、小剂量芪归3∶1组、大剂量芪归3∶1组、小剂量芪归3∶2组、大剂量芪归3∶2组,每组各6例。对照组给予常规治疗,各芪归药对组在常规治疗基础上加服不同剂量、不同配比的黄芪、当归,各组均治疗90 d。治疗后,比较各组血清NO、NOS水平,肝肾功能及不良反应情况。结果:治疗后,与对照组比较,各芪归药对组血清NO、NOS水平均下降,其中以大剂量芪归3∶2组下降最为明显,差异有统计学意义(P0.05);且相同配比情况下,大剂量组的血清NO、NOS水平明显低于小剂量组,差异有统计学意义(P0.05)。各组治疗前后肝肾功能均未见明显异常,治疗过程中均未出现不良反应。结论:黄芪当归3∶2配比能更好地改善早期DN患者血清NO和NOS水平,该配比具有良好的临床安全性,可用于治疗早期DN。

Effect of Drug Pair of Huangqi(Astragali Radix) and Danggui(Angelicae Sinensis Radix)on Serum Nitric Oxide and Nitric Oxide Synthase in Patients with Early Diabetic Nephropathy of Qi Deficiency and Blood Stasis Syndrome

Objective:By observing the levels of nitric oxide(NO) and nitric oxide synthase(NOS) in serum of patients with early diabetic nephropathy(DN),to explore the mechanism of different compatibility ratio of Huangqi(Astragali Radix) and Danggui(Angelicae Sinensis Radix) in the treatment of early DN,and to determine the optimal dose-effect relationship.Methods:A total of 42 patients with DN of qi deficiency and blood stasis syndrome were randomly divided into 7 groups,including control group,small dose of Huangqi and Danggui(Qigui) in the ratio of 5∶1 group,large dose of Qigui in the ratio of 5∶1 group,small dose of Qigui in the ratio of 3 ∶1 group,large dose of Qigui in the ratio of 3 ∶1 group,small dose of Qigui in the ratio of 3∶2 group and large dose of Qigui in the ratio of 3∶2 group,with 6 cases in each group. The control group was given conventional treatment,while the other groups was given Huangqi and Danggui in different dose and different ratio on the basis of conventional treatment. All the groups were treated for 90 days. After treatment,the levels of NO and NOS in serum,liver and kidney function and adverse reactions of all the groups were compared. Results:After treatment,compared with the control group,the levels of NO and NOS in each Qigui group were decreased,and the decrease in the large dose of Qigui in the ratio of 3∶2 group was most obvious. The difference was statistically significant(P<0.05).For groups with same ratio of Huangqi and Danggui,the levels of NOS and NO in the large dose group were significantly lower than those in the small dose group and the differences were statistically significant(P<0.05). In all the groups,there were no obvious abnormalities in liver and kidney function before and after treatment,and no adverse reactions appeared during the treatment. Conclusions:Huangqi and Danggui in the ratio of 3 ∶2 can better improve the serum NO and NOS levels in patients with DN. This ratio is safe in clinic and can be used to treat early DN.