【摘要】 目的:探讨益肾活血颗粒对气虚血瘀型早期糖尿病肾病患者患者纤维化的影响及其对结缔组织生长因子(Connective Tissue Growth Factor,CTGF)的作用。方法:将90例气虚血瘀型2型糖尿病肾病(Diabetic Nephropathy,DN)患者采用采用随机信封方式分为常规组和治疗组,每组各45例,另将同期45例健康体检者设为对照组,其中2组DN患者均接受积极控制血糖,治疗高血压,调节脂质代谢异常等治疗,治疗组则在该基础上加用益肾活血颗粒。2组均以12周为1个疗程,于治疗前及治疗12周后检测3组蛋白尿排泄率(u AER)、糖化血红蛋白(Hb Alc)、空腹血糖(FGC)、餐后2 h血糖(2 h BG)、I、Ⅲ型胶原(PI NP、PⅢNP)以及尿结缔组织生长因子(CTGF)的变化。结果:1)2组患者治疗前24 h蛋白尿排泄率、Hb Alc、FGC、2 h BG比较差异无统计学意义(P>0.05),2组治疗后24 h蛋白尿排泄率、FPG、OGTT均较治疗前降低,与常规组比较,治疗组降低的程度较为明显(P<0.05);治疗组的临床有效率明显高于对照组(P<0.05)。2)治疗前相比,治疗12周后治疗组和常规治疗组患者u AER、I、Ⅲ型胶原以及CTGF水平均有明显下降(P<0.01),其中治疗组上述指标均显著低于常规治疗组(P<0.05)。3)利用Spearman法进行相关参数相关性分析后可知CTGF与PI NP、PⅢNP均具有正相关性(P<0.05)。结论:益肾活血颗粒可以显著降低尿CTGF水平,该效应可能是益肾活血颗粒防治气虚血瘀型早期糖尿病肾病纤维化的作用机制之一。更多还原

【Abstract】 Objective: To investigate the impact of Yishenhuoxue granules on fibrosis of patients with qi deficiency and blood stasis type of early diabetic nephropathy and its effect on CTGF. Methods: 90 cases of patients with qi deficiency and blood stasis type of type 2 diabetic nephropathy( DN) were divided into normal group and observation group by using random envelope,45 cases in each group,45 cases of healthy physical examination in the corresponding period as healthy control group,both of the two groups of patients with DN accepted the treatment such as positive control of blood glucose,high blood pressure treatment,adjusted abnormal lipids metabolism,the observation group added Yishenhuoxue granules based on the treatment. Both of the two groups according to12 weeks for a period of treatment,tested the changes of three sets of albuminuria excretion rate( u AER) and collagen type I,Ⅲ( PI NP,P Ⅲ NP),and connective tissue growth factor( CTGF) of the urine before and after 12 weeks of treatment. Results: 1) 24 h before the treatment,urine protein excretion rate,Hb Alc,FGC,2 h BG of the two groups of patients were with no statistical differences( P > 0. 05),24 h after the treatment,urine protein excretion rate,FPG,OGTT of the two groups reduced compared to before the treatment,and the comparison with the conventional group,the observation group reduced the more obvious extent( P < 0. 05);The clinical effectiveness of observation group was obviously higher than that of control group( P < 0. 05). 2) Compared with before treatment,u AER,collagen type I,Ⅲ and CTGF levels in patients of observation group and conventional therapy group were significantly decreased after 12 weeks( P < 0. 01),the indexes above of the observation group were significantly lower than that of conventional treatment group( P < 0. 05). 3) After related parameters correlation analysis by using of Spearman method,it showed CTGF and PI NP,P Ⅲ NP had positive correlation( P < 0. 05). Conclusion: Yishenhuoxue granules can significantly reduce urinary CTGF level,this effect may be one of the mechanism of Yishenhuoxue granules prevent and treat qi deficiency and blood stasis type of early diabetic nephropathy fibrosis.更多还原