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目的观察糖肾康颗粒对糖尿病肾病(diabetic nephropathy,DN)气阴两虚血瘀证患者血清同型半胱氨酸(homocysteine,Hcy)及脂质代谢紊乱的干预作用。方法将60例DN气阴两虚血瘀证患者随机分为试验组和对照组各30例,在降压治疗基础上,试验组给予糖肾康颗粒冲服,对照组给予缬沙坦胶囊口服。治疗16周后,检测尿微量白蛋白/尿肌酐比值(urine albumin-to-creatinine ratio,UACR)、24h尿蛋白(24-hour proteinuria,24hUpro)、血肌酐(serum creatinine,SCr)、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、血清Hcy、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、载脂蛋白-A1(apolipoprotein A1,ApoA1)、载脂蛋白-B(apolipoprotein B,ApoB)。结果试验组疾病疗效显著优于对照组(P<0.05)。两组患者治疗后UACR、24hUpro、SCr均较治疗前显著降低(P<0.05),eGFR较治疗前显著升高(P<0.05);且试验组治疗后UACR和24hUpro降低值显著大于对照组(P<0.05)。试验组血清Hcy、TC、LDL-C、ApoB与治疗前比较均显著降低(P<0.05),而对照组治疗后血清Hcy、TC、LDL-C、ApoB均无明显变化(P>0.05),试验组治疗后Hcy、LDL-C、ApoB降低值显著大于对照组(P<0.05)。结论糖肾康颗粒降低DN气阴两虚血瘀证患者蛋白尿、改善肾功能的作用机制与改善高半胱氨酸血症和脂质代谢紊乱有关。
Objective To observe the effect of Tangshenkang granule on serum homocysteine (Hcy) and lipid metabolism disorder in patients with diabetic nephropathy (DN) with deficiency of both qi and blood. Methods Sixty patients with deficiency of qi and yin and blood of both sides of the blood stasis syndrome were randomly divided into experimental group and control group of 30 cases. On the basis of antihypertensive treatment, the rats in the experimental group were given Tangshenkang granules and the control group were given valsartan capsules orally. After 16 weeks of treatment, urinary albumin-to-creatinine ratio (UACR), 24-hour proteinuria (24hUpro), serum creatinine (SCr) The estimated glomerular filtration rate (eGFR), serum Hcy, total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL- , High density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB). Results The efficacy of disease in experimental group was significantly better than that in control group (P <0.05). The UACR, 24hUpro and SCr after treatment in both groups were significantly lower than those before treatment (P <0.05), eGFR was significantly higher than before treatment (P <0.05), and the reduction of UACR and 24hUpro in experimental group was significantly greater than that of the control group P <0.05). The levels of serum Hcy, TC, LDL-C and ApoB in the experimental group were significantly lower than those before treatment (P <0.05), while the levels of Hcy, TC, LDL- The reduction of Hcy, LDL-C and ApoB in the experimental group was significantly greater than that in the control group (P <0.05). Conclusion Tangshenkang granules can reduce proteinuria and improve renal function in DN patients with deficiency of both qi and yin and blood stasis, and its mechanism is related to the improvement of hypercysteinemia and dyslipidemia.