雷公藤多苷片联合百令胶囊对糖尿病肾病Ⅳ期患者中医证候积分、脂肪细胞因子及肾纤维化的影响

Effects of Tripterygium Glycoside Tablets Combined with Bailing Capsule on TCM Syndrome Score,Adipocytokines and Renal Fibrosis in Patients with StageⅣDiabetic Nephropathy

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摘要目的探讨雷公藤多苷片联合百令胶囊对糖尿病肾病Ⅳ期患者中医证候积分、脂肪细胞因子及肾纤维化的影响。方法选择2017年1月至2021年6月收治的糖尿病肾病Ⅳ期患者80例,按治疗方法不同分为百令组40例和联合组40例。2组均给予常规治疗,百令组给予百令胶囊治疗,联合组给予百令胶囊联合雷公藤多苷片治疗。比较2组治疗前和治疗6个月后中医证候积分、血清脂联素、Chemerin、胱抑素C以及血清、尿转化生长因子-β1(TGF-β1)水平,观察2组不良反应发生情况。结果治疗后,联合组气短乏力、腰膝酸软、肢体麻木、水肿中医证候积分均低于治疗前和百令组(P<0.05)。治疗后,联合组血清脂联素水平均高于治疗前和百令组(P<0.05);治疗后,联合组血清Chemerin、胱抑素C以及血清、尿TGF-β1水平均较治疗前和百令组降低(P<0.05)。联合组治疗期间发生肝损伤2例、骨髓抑制(表现为白细胞减少)1例,均较轻微,给予相应干预后好转。百令组无不良反应发生。结论雷公藤多苷片联合百令胶囊治疗糖尿病肾病Ⅳ期患者可以减轻中医证候、调节血清脂联素、Chemerin水平,且对肾纤维化有明显改善作用。 Objective To investigate the effects of Tripterygium Glycoside tablets combined with Bailing capsule on traditional Chinese medicine(TCM)syndrome score,adipocytokines and renal fibrosis in patients with stageⅣdiabetic nephropathy(DN).Methods A total of 80 patients with stageⅣDN treated from January 2017 to June 2021 were selected and divided into Bailing group(n=40)and combination group(n=40)according to different treatment methods.The two groups were given conventional treatment,the Bailing group was given Bailing capsule,and the combination group was given Bailing capsule combined with Tripterygium Glycoside tablets.TCM syndrome scores,serum adiponectin,Chemerin,cystatin C(CysC)and serum and urine transforming growth factor-β1(TGF-β1)levels were compared between the two groups before treatment and at 6 months after treatment.The occurrence of adverse reactions in the two groups was compared.Results After treatment,the TCM syndrome scores for shortness of breath,weakness of waist and knees,numbness of limbs and edema in combination group were lower than those before treatment and in Bailing group(P<0.05).After treatment,the serum adiponectin level in combination group was higher than those before treatment and in Bailing group(P<0.05).After treatment,the levels of Chemerin,CysC and TGF-β1 in serum and urine in combination group were lower than those before treatment and in Bailing group(P<0.05).In combination group,there were 2 patients with liver injury and 1 patient with myelosuppression(leukopenia)during treatment,all of which were mild and improved after corresponding intervention.No adverse reaction was reported in the Bailing group.Conclusion Tripterygium Glycoside tablets combined with Bailing capsule in the treatment of patients with stageⅣDN can alleviate the TCM syndrome,regulate the levels of serum adiponectin and Chemerin,and have a significant effect on the improvement on renal fibrosis.

作者左建娇魏萱李刚王津李玉婵施云涛张晓亚 ZUO Jianjiao;WEI Xuan;LI Gang;WANG Jin;LI Yuchan;SHI Yuntao;ZHANG Xiaoya(Department of Spleen and Stomach Diseases,East Branch of Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of Medical Section,East Branch of Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;the First Department of Endocrinology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of General Internal Medicine,West Branch of Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of Oncology Section Two,Tongzhou District,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101121,China)

机构地区石家庄市中医院东院区脾胃病科石家庄市中医院东院医务科石家庄市中医院内分泌一科河北省中医院西院区综合内科北京中医药大学东直门医院通州院区肿瘤科二区

出处《临床误诊误治》 2025年第4期83-87,共5页 Clinical Misdiagnosis & Mistherapy

基金河北省中医药管理局项目(2021246)。

关键词糖尿病肾病雷公藤多苷片百令胶囊中医证候脂联素 CHEMERIN 胱抑素C 转化生长因子-β1 Diabetic nephropathy Tripterygium Glycoside tablets Bailing capsule Traditional Chinese medicine syndrome Adiponectin Chemerin Cystain C Transforming growth factor-β1

分类号 R587.2 [医药卫生—内分泌]

作者简介左建娇,硕士研究生,副主任中医师。主要从事中医内科临床治疗肾病及脾胃病方向研究。