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目的 探讨黄芪注射液对糖尿病肾病 (DN)的治疗作用及机理。方法 90例 2型糖尿病患者根据微量白蛋白排泄率分为正常蛋白尿组 (A组 )、微量白蛋白尿组 (B组 )、临床蛋白尿组 (C组 ) ,分别检测其血糖、糖化血红蛋白、血尿素氮、肌酐、Ⅳ型胶原、转化生长因子 β1 。A、B、C 3组又随机分为黄芪注射液治疗组和常规治疗组。结果 糖尿病各组HbA1c、尿微量白蛋白 (UAER)、血清Ⅳ型胶原、TGF β1 水平均显著增高。相关分析表明血清Ⅳ型胶原、TGF β1 、HbA1c与Cr、UAER呈正相关 ,HbA1c、TGF β1 与血清Ⅳ型胶原呈正相关。黄芪注射液治疗组治疗后HbA1c、UAER、血清Ⅳ型胶原、TGF β1 均显著降低。结论 糖尿病患者存在胶原代谢异常 ,且与TGF β1 、非酶糖化有关。黄芪注射液能减少TGF β1 的产生、降低非酶糖化 ,抑制肾脏纤维化、保护肾脏功能
Objective To investigate the therapeutic effect and mechanism of astragalus injection on diabetic nephropathy (DN). Methods Ninety patients with type 2 diabetes mellitus were divided into normal proteinuria group (group A), microalbuminuria group (group B) and clinical proteinuria group (group C) according to their excretion rate of microalbuminuria. Blood glucose, hemoglobin A1c , Blood urea nitrogen, creatinine, type Ⅳ collagen, transforming growth factor β1. A, B and C 3 groups were randomly divided into astragalus injection group and conventional treatment group. Results The levels of HbA1c, urine microalbumin (UAER), serum type Ⅳ collagen and TGFβ1 in diabetes mellitus group were significantly increased. Correlation analysis showed that serum type Ⅳ collagen, TGF β1, HbA1c and Cr, UAER was positively correlated, HbA1c, TGF β1 and serum type Ⅳ collagen was positively correlated. Astragalus injection treatment group after treatment HbA1c, UAER, serum type Ⅳ collagen, TGF β1 were significantly lower. Conclusion Diabetic patients have abnormal collagen metabolism, which is related to TGFβ1 and non-enzymatic glycation. Astragalus injection can reduce the production of TGF β1, reduce non-enzymatic glycation, inhibit renal fibrosis and protect renal function