CAJ | 학술논문

目的：观察中药复方糖肾宝冲剂治疗Ⅳ期糖尿病肾病（ DN）的临床疗效及可能作用机制。方法：将84例Ⅳ期DN患者，按随机数字表法分为治疗组和对照组，每组各42例。对照组采用基础治疗，治疗组在对照组的基础上给予糖肾宝冲剂冲服，每日2次，疗程16周。治疗结束后，观察治疗前后两组的中医症状积分、血糖、血清肌酐（ Scr）、尿白蛋白排泄率（UAER）、N-乙酰β-D氨基葡萄糖苷酶（NAG）、单核细胞趋化蛋白（MCP-1）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）等的变化。结果：（1）治疗后两组中医症状积分明显降低（P<0．01），但治疗组明显低于对照组（P<0．01）。（2）治疗前后两组血糖、Scr差异无统计学意义（P>0．05）；治疗后两组UAER明显改善（P<0．01），但治疗组较对照组改善更显著（P<0．05）；治疗后治疗组尿NAG显著改善（P<0．01），而对照组改善不明显（P>0．05）。（3）治疗后两组MCP-1、IL-6及TNF-α均显著改善（P<0.01，P<0．05），但治疗组较对照组改善更显著（P<0.01，P<0．05）。结论：糖肾宝冲剂能改善Ⅳ期DN患者的临床症状，减轻肾损害，其作用机制可能与抑制炎症状态有关。
목적：관찰중약복방당신보충제치료Ⅳ기당뇨병신병（ DN）적림상료효급가능작용궤제。방법：장84례Ⅳ기DN환자，안수궤수자표법분위치료조화대조조，매조각42례。대조조채용기출치료，치료조재대조조적기출상급여당신보충제충복，매일2차，료정16주。치료결속후，관찰치료전후량조적중의증상적분、혈당、혈청기항（ Scr）、뇨백단백배설솔（UAER）、N-을선β-D안기포도당감매（NAG）、단핵세포추화단백（MCP-1）、백세포개소-6（IL-6）급종류배사인자-α（TNF-α）등적변화。결과：（1）치료후량조중의증상적분명현강저（P<0．01），단치료조명현저우대조조（P<0．01）。（2）치료전후량조혈당、Scr차이무통계학의의（P>0．05）；치료후량조UAER명현개선（P<0．01），단치료조교대조조개선경현저（P<0．05）；치료후치료조뇨NAG현저개선（P<0．01），이대조조개선불명현（P>0．05）。（3）치료후량조MCP-1、IL-6급TNF-α균현저개선（P<0.01，P<0．05），단치료조교대조조개선경현저（P<0.01，P<0．05）。결론：당신보충제능개선Ⅳ기DN환자적림상증상，감경신손해，기작용궤제가능여억제염증상태유관。
Objective:To investigate the clinical efficacy and the possible action mechanism of Chinese herbal compound Tangshenbao Granules in treating the 4th stage of the Diabetic Nephropathy(DN). Methods:84 patients in the stageⅣof DN were equally randomly divided into the treated group and the control group. Vonventiona treatment was given to all patients and the treated group was administered with Tangshenbao Granules twice a day additionally for 16 weeks. Changes of symptoms were observed,and laboratory indexes,as blood glucose,Serum Creatine( Scr),Urinary albumin excretion rate( UAER),acetylgcosamidase( NAG), monocyte chemoattractant protein-1(MCP-1),inter leukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected be-fore and after treatment. Results:(1)The symptom integral has reduced obviously in the two groups after treatment(P<0. 01),but the reduction was more obvious in the treat group than that in the control group(P<0. 01).(2)Blood glucose and SCr were no sig-nificant differences before and after treatment(P>0. 05);UARE was certainly improved in the two groups(P<0. 01),and more im-provement was achieved in the treat group than that in the control group(P<0. 05);NAG was significantly improved in the treat group(P<0. 01),while there is no obvious improvement in the treat group(P>0. 05).(3)MCP-1 IL-6 and TNF-αwere sig-nificantly improved in the two groups(P<0. 01,P<0. 05),however the improvement was more significant in the treat group than the control group(P<0. 01,P<0. 05). Conclusion:Tangshenbao Granules could improve the clinical effect of patients in the stageⅣof DN and alleviate the damage of kidney. Its action mechanism may be related to inhibit inflammation state.