CAJ | 학술논문

目的：探讨糖肾化浊方对IV期糖尿病肾病（diabetic nephropathy，DN）患者血清转化生长因子-β1（TGF-β1）和血小板源生长因子（PDGF）浓度的影响。方法收集2012年6-12月在首都医科大学附属北京同仁医院就诊的IV期DN患者98例，采用随机数字表法将患者分为治疗组（48例）和对照组（50例），均采用常规降糖、降压、调脂和抗凝治疗，停服血管紧张素转化酶抑制药或其他血管紧张素 II受体拮抗药。对照组在此基础上口服厄贝沙坦，150 mg/d。治疗组在对照组治疗基础上加服糖肾化浊方。两组治疗后6个月检测血清TGF-β1和PDGF浓度，并观察尿微量白蛋白排泄率（UAER）、血尿素氮（BUN）、血肌酐（Scr）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）的变化。结果治疗后，治疗组TGF-β1、PDGF水平[（123.6±21.2）pg/ml、（500.6±130.2）pg/ml]较同组治疗前[（172.5±31.3）pg/ml、（860.9±131.2）pg/ml]明显下降（P＜0.01），且与对照组治疗后[（157.4±39.6）pg/ml、（765.7±161.8）pg/ml]比较，差异有统计学意义（P＜0.01）。治疗后治疗组TG、TC、HDL-C、LDL-C、UAER[（1.72±0.25）mmol/L、（4.56±0.64）mmol/L、（1.56±0.50）mmol/L、（2.46±1.08）mmol/L、（100.73±204.24）μg/min]均优于对照组[（2.09±0.27）mmol/L、（6.11±0.93）mmol/L、（1.36±0.44）mmol/L、（3.32±0.87）mmol/L、（226.24±396.38）μg/min，P＜0.05或0.01]。结论糖肾化浊方可降低IV期DN患者血清TGF-β、PDGF浓度，抑制或改善肾小球硬化发生、发展过程。
목적：탐토당신화탁방대IV기당뇨병신병（diabetic nephropathy，DN）환자혈청전화생장인자-β1（TGF-β1）화혈소판원생장인자（PDGF）농도적영향。방법수집2012년6-12월재수도의과대학부속북경동인의원취진적IV기DN환자98례，채용수궤수자표법장환자분위치료조（48례）화대조조（50례），균채용상규강당、강압、조지화항응치료，정복혈관긴장소전화매억제약혹기타혈관긴장소 II수체길항약。대조조재차기출상구복액패사탄，150 mg/d。치료조재대조조치료기출상가복당신화탁방。량조치료후6개월검측혈청TGF-β1화PDGF농도，병관찰뇨미량백단백배설솔（UAER）、혈뇨소담（BUN）、혈기항（Scr）、당화혈홍단백（HbA1c）、삼선감유（TG）、총담고순（TC）、저밀도지단백담고순（LDL-C）、고밀도지단백담고순（HDL-C）적변화。결과치료후，치료조TGF-β1、PDGF수평[（123.6±21.2）pg/ml、（500.6±130.2）pg/ml]교동조치료전[（172.5±31.3）pg/ml、（860.9±131.2）pg/ml]명현하강（P＜0.01），차여대조조치료후[（157.4±39.6）pg/ml、（765.7±161.8）pg/ml]비교，차이유통계학의의（P＜0.01）。치료후치료조TG、TC、HDL-C、LDL-C、UAER[（1.72±0.25）mmol/L、（4.56±0.64）mmol/L、（1.56±0.50）mmol/L、（2.46±1.08）mmol/L、（100.73±204.24）μg/min]균우우대조조[（2.09±0.27）mmol/L、（6.11±0.93）mmol/L、（1.36±0.44）mmol/L、（3.32±0.87）mmol/L、（226.24±396.38）μg/min，P＜0.05혹0.01]。결론당신화탁방가강저IV기DN환자혈청TGF-β、PDGF농도，억제혹개선신소구경화발생、발전과정。
Objective To investigate the effect of extract ofTangshen-HuazhuoRecipe(TSHZR) on the serum concentrations of transforming growth factorβ1(TGF-β1) and platelet derived growth factor(PDGF) in patients withⅣ stage of diabetic nephropathy(DN).Methods From June 2012 to December 2012, 98 patients ofⅣstage DN in our hospital outpatient were enrolled and randomly divided into treatment group(n=48) and control group(n=50) using random number table. All patients received conventional therapies of controlling blood sugar, lipid, blood pressure and anticoagulant therapy. On such basis, the control group was treated by irbesartan, 150 mg/d, and the treated group treated by TSHZR combined with irbesartan,150 mg/d, for 6 months. Serum TGF-β1 and PDGF were determined with ELISA before and after treatment,and urinary albumin excretion rate,HbA1c,serum creatinine,blood urea nitrogen and lipid profiles were examined as well. ResultsIn the treated group, the TGF-β1 was(172.5±31.3), (123.6±21.2)pg/ml, the PDGF was(860.9± 131.2), (500.6±130.2)pg/ml before the treatment and after the treatment, respectively. The TGF-β1 and PDGF after the treatment were significantly decreased than those before the treatment(P<0.01). After the treatment, TGF-β1 and PDGF in the treated group were statistically significant compared to the control group[TGF-β1 is(157.4±39.6)pg/ml, PDGF is(765.7±161.8)]pg/ml,P<0.01). After the treatment, the treatment group was superior to the control group in TG(1.72±0.25)mmol/L,(2.09±0.27)mmol/L,(P<0.01), TC(4.56± 0.64)mmol/L,(6.11±0.93)mmol/L, (P<0.01), HDL-C(1.56±0.50)mmol/L,(1.36±0.44)mmol/L, (P<0.01), LDL-C(2.46±1.08)mmol/L(3.32±0.87)mmol/L,(P<0.05)and UAER(100.73±204.24)μg/min, (226.24±396.38)μg/min, (P<0.01).Conclusion TSHZR can inhibit the progressive of IV stage of diabetic nephropathy by suppressing TGF-β1 and PDGF expression level.