摘要
目的:益肾通络方加减联合达格列净对糖尿病肾病(DKD)肝肾阴虚兼血瘀证患者血糖控制、肾功能、氧化应激、炎症因子的影响及作用机制分析。方法:将90例DKD肝肾阴虚兼血瘀证患者随机分为观察组和对照组,每组45例。两组均给予DKD的常规治疗。观察组予以达格列净联合益肾通络方加减治疗,对照组仅以达格列净治疗,两组均治疗12周。比较两组患者治疗前后中医证候积分、尿白蛋白/肌酐(UACR)、血糖水平[空腹血糖(FBG)、餐后2 h血糖(2 h PG)和糖化血红蛋白(HbA1c)]、肾功能[血尿素氮(BUN)、肾小球滤过率(eGFR)]以及氧化应激相关指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期蛋白氧化产物(AOPPs)],炎症指标[肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),超敏C反应蛋白(hs-CRP)],并评估其安全性。结果:治疗后,观察组患者总有效率(88.89%)高于对照组(66.67%),差异有统计学意义(P<0.01);治疗后,两组患者各项中医证候积分、FBG、2 h PG、HbA1c,血清MDA、AOPPs、UACR、BUN、TNF-α、IL-6、hs-CRP水平均下降,SOD、eGFR水平均升高,且观察组患者上述指标改善情况明显优于对照组,差异有统计学意义(P<0.05,P<0.01)。两组患者治疗期间均未发生不良反应。结论:益肾通络方加减联合达格列净可显著改善DKD肝肾阴虚兼血瘀证患者的血糖控制水平,减少氧化应激反应,抑制炎症反应,促进肾功能恢复。其作用机制可能与抗氧化、抗炎、调节血糖代谢、改善肾小球滤过功能等有关。
Objective:To analyze the effects of modified Yishen Tongluo Formula combined with dapagliflozin on glycemic control,renal function,oxidative stress and inflammatory factors in patients with diabetic kidney disease(DKD)with liver-kidney Yin-deficiency and blood stasis syndrome,and to explore its underlying mechanisms.Methods:A total of 90 DKD patients with with liver-kidney Yin-deficiency and blood stasis syndrome were randomly divided into an observation group and a control group,with 45 cases in each group.Both groups of patients were given the conventional treatment for DKD.Patients in the observation group received dapagliflozin combined with modified Yishen Tongluo Formula,while patients in the control group received dapagliflozin alone.Both groups were treated for 12 weeks.Traditional Chinese medicine(TCM)syndrome scores,urinary albumin-to-creatinine ratio(UACR),glycemic levels[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PG)and glycated hemoglobin(HbA1c)],renal function indices[blood urea nitrogen(BUN)and estimated glomerular filtration rate(eGFR)],oxidative stress-related markers[superoxide dismutase(SOD),malondialdehyde(MDA)and advanced oxidation protein products(AOPPs)],and inflammatory markers[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)]were compared between the two groups before and after treatment.Safety was also evaluated.Results:After treatment,the total effective rate in the observation group(88.89%)was higher than that in the control group(66.67%),with a statistically significant difference(P<0.01).After treatment,TCM syndrome scores,FBG,2 h PG,HbA1c,serum MDA,AOPPs,UACR,BUN,TNF-α,IL-6 and hs-CRP levels decreased in both groups,while SOD and eGFR levels increased.The improvements in these indicators were significantly more pronounced in the observation group compared to the control group,with statistically significant differences(P<0.05,P<0.01).No adverse reactions occurred in either group during the treatment period.Conclusion:Yishen Tongluo Formula combined with dapagliflozin significantly improves glycemic control,reduces oxidative stress,inhibits inflammatory responses and promotes renal function recovery in DKD patients with with liverkidney Yin-deficiency and blood stasis syndrome.Its mechanisms of action may be related to antioxidant,antiinflammatory,glycemic regulation and improvement of glomerular filtration function.
作者
严瑜珊
刘剑
方朝晖
王奔
宋梦茹
金冶
王允
Yan Yushan;Liu Jian;Fang Zhaohui;Wang Ben;Song Mengru;Jin Ye;Wang Yun(The First Clinical Medical College of Anhui University of Chinese Medicine,Hefei Anhui 230038;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230031)
出处
《山西中医药大学学报》
2025年第10期1116-1122,共7页
Journal of Shanxi University of Chinese Medicine
基金
国家重点研发项目计划(2022YFE0201800)
安徽省高校自然科学基金项目(KJ202110560)
方朝晖安徽省名中医工作室((2019)-8-515)。
关键词
糖尿病肾病
益肾通络方
肝肾阴虚兼血瘀证
肾功能
氧化应激
炎症反应
DKD
Yishen Tongluo Formula
liver-kidney Yin-deficiency and blood stasis syndrome
renal function
oxidative stress
inflammatory response
