健脾益肾活血方联合达格列净对糖尿病肾病患者炎症因子、氧化应激和血清AGEs、NGAL、MCP-1的影响

摘要 目的：观察健脾益肾活血方联合达格列净对糖尿病肾病（DN）患者炎症因子、氧化应激和血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、晚期糖基化终末产物（AGEs）、单核细胞趋化蛋白1（MCP-1）的影响。方法：根据随机数字表法将如皋市中医院2021年6月~2023年3月期间收治的120例DN患者分为对照组（60例，常规治疗基础上接受达格列净治疗）和研究组（60例，对照组基础上接受健脾益肾活血方治疗）。对比两组疗效、炎症因子[白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）]、肾功能[血肌酐（Scr）、血尿素氮（BUN）、尿微量白蛋白/肌酐比值（UACR）]、氧化应激[丙二醛（MDA）、超氧化物歧化酶（SOD）]和血清AGEs、NGAL、MCP-1水平，同时观察两组治疗期间不良反应发生情况。结果：研究组的临床总有效率高于对照组（P<0.05）。两组治疗2个疗程后Scr、BUN、UACR下降，且研究组低于对照组（P<0.05）。两组治疗2个疗程后CRP、TNF-α、IL-1β下降，且研究组低于对照组（P<0.05）。两组治疗2个疗程后MDA下降，且研究组低于对照组；SOD升高，且研究组高于对照组（P<0.05）。两组治疗2个疗程后NGAL、AGEs、MCP-1下降，且研究组低于对照组（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：健脾益肾活血方联合达格列净可有效减轻DN患者氧化应激和炎症反应，调节血清AGEs、NGAL、MCP-1水平。

Effects of Jianpi Yishen Huoxue Decoction Combined with Dapagliflozin on Inflammatory Factors, Oxidative Stress and Serum AGEs, NGAL and MCP-1 in Patients with Diabetic Nephropathy

ABSTRACT Objective: To observe the effects of jianpi yishen huoxue decoction combine with dapagliflozin on inflammatory factors, oxidative stress and serum neutrophil gelatinase associated lipocalin (NGAL), advanced glycation end products (AGEs) and monocyte chemoattractant protein 1 (MCP-1) in patients with diabetic nephropathy (DN). Methods: 120 DN patients who were admitted to Rugao Hospital of Traditional Chinese Medicine from June 2021 to March 2023 were divided into control group (60 cases, treated with dapagliflozin on the basis of routine treatment ) and study group (60 cases, treated with jianpi yishen huoxue decoction on the basis of control group) according to the random number table method.The efficacy, inflammatory factors [interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), C reactive protein (CRP)], renal function [serum creatinine (Scr), blood urea nitrogen (BUN), Urinary microalbumin/creatinine ratio (UACR)], oxidative stress [malondialdehyde (MDA), superoxide dismutase (SOD)] and serum AGEs, NGAL, MCP-1 levels were compared between two groups, and the occurrence of adverse reactions during treatment was observed. Results: The total clinical effective rate in study group was higher than that in control group (P<0.05). Scr、BUN and UACRdecreased in two groups 2 courses after treatment, and study group were lower than those of control group (P<0.05). CRP, TNF-α and IL-1β in two groups decreased 2 courses after treatment, and study group were lower than those of control group (P<0.05). MDA decreased in two groups 2 courses after treatment, and study group was lower than that of control group. SOD increased, and study group was higher than that of control group (P<0.05). NGAL, AGEs and MCP-1 decreased in two groups 2 courses after treatment, and study group were lower than those of control group (P<0.05). There was no difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion: Jianpi yishen huoxue decoction combine with dapagliflozin can effectively reduce oxidative stress and inflammatory response in DN patients, and regulate the levels of serum AGEs, NGAL and MCP-1.