葛根芩连汤加减对糖尿病肾病血管内皮细胞因子及尿蛋白排泄率的影响

目的:探讨葛根芩连汤加减对湿热型糖尿病肾病的临床疗效,同时观察其对患者血管内皮细胞因子及尿蛋白排泄率的影响。方法:选取70例湿热型糖尿病肾病患者,随机分为对照组及观察组,各35例。2组患者均接受内科常规治疗,观察组在对照组治疗基础上加用葛根芩连汤加减,2组均连续治疗8周,治疗前后均对2组患者中医证候积分、尿微量白蛋白排泄率(m Alb)、24 h尿蛋白定量(Upro/24 h)、血肌酐(Scr)、糖基化血红蛋白(Hb Alc)、尿素氮(BUN)、餐后2 h血糖(FPG)、三酰甘油(TG)以及外周血管内皮生长因子(VEGF)水平进行检测。结果:治疗后2组患者中医证候积分均有所下降,其中观察组下降的趋势更为明显(P0.05);葛根芩连汤加减能够更明显得下调糖尿病肾病患者m Alb、Upro/24 h、Scr、BUN、Hb Alc、FPG、TG的水平,2组比较差异有统计学意义(P0.05);2组治疗后VEGF均较治疗前下降,其中加用观察组患者下降的幅度更大(P0.05)。结论:葛根芩连汤加减对湿热型糖尿病肾病有理想疗效,可明显改善患者临床症状,纠正脂代谢紊乱,且通过阻断VEGF的分泌可能可以实现治疗糖尿病肾病的目的。

Effects of Modified Gegen Qinlian Decoction on Vascular Endothelial Growth Factor and Urinary Albumin Excretion Rate in the Treatment of Diabetic Nephropathy

To discuss the clinical curative effects of modified Gegen Qinlian Decoction on damp-heat type diabetic nephropathy, and observe the effects on vascular endothelial growth factor and urinary albumin excretion rate of the patients. Methods: A total of 70 patients with damp-heat type diabetic nephropathy who were admitted and treated in People''s Hospital of Hubei Medical College from April 2011 to April 2016 were selected into the study. All patients were randomly divided into control group and observation group, 35 cases in each group. The two groups of patients were treated with conventional treatment, and the observation group was treated with modified Gegen Qinlian Decoction based on the conventional treatment. Both of the two groups were continuously treated for 8 weeks. Levels of TCM syndrome integration, urine trace albumin excretion rate (mAlb), 24 hour urine protein quantitation (Upro/24 h), serum creatinine (Scr), glycosylated hemoglobin (HbAlc), urea nitrogen (BUN), 2 hour postprandial blood glucose (FPG), triglycerides (TG) and peripheral blood vascular endothelial growth factor (uVEGF) of two groups were detected before and after treatment. Results: TCM syndrome integration in the two groups both declined after treatment, and it was more significantly in the observation group (P<0.05). The modified Gegen Qinlian Decoction can evidently decrease the levels of mAlb, Upro/24 h, Scr, BUN, HbAlc, FPG, TG, which had statistical significance compared with the two groups (P<0.05). VEGF level of the two groups both declined after treatment, and the decrease of observation group was more sharply (P<0.05). Conclusion: Modified Gegen Qinlian Decoction has ideal curative effect on damp-heat type diabetic nephropathy, which can significantly improve the patients'' clinical symptoms and correct the lipid metabolism disorders, and may achieve the goal of treatment for diabetic nephropathy by blocking uVEGF secretion.