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【目的】观察丹蛭降糖胶囊对糖尿病肾病(DKD)早期患者血清白细胞介素18(IL-18)、胱抑素C(Cys C)及相关指标的影响,探讨丹蛭降糖胶囊对肾脏的保护作用。【方法】选取在安徽中医药大学第一附属医院内分泌科住院的62例早期糖尿病肾病患者,分为西药组和丹蛭降糖胶囊组(简称DJC组),每组31例。西药组给予常规降糖药和贝那普利治疗,DJC组在西药组的基础上给予口服丹蛭降糖胶囊。观察2组患者治疗前后血清IL-18、Cys C及空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)、血肌酐(SCr)、尿素氮(BUN)、尿微量白蛋白(m Alb)、尿白蛋白肌酐比值(UACR)、肾小球滤过率(e GFR)表达水平。【结果】DJC组总有效率为90.0%,西药组为76.7%,DJC组疗效优于西药组(P<0.05)。治疗后,DJC组的中医主要证候积分较治疗前显著下降,且其改善程度优于西药组(P<0.05或P<0.01)。治疗后,2组患者血清IL-18、Cys C、2h PG、SCr、BUN、m ALB、UACR水平均较治疗前显著下降,e GFR水平均较治疗前显著升高(P<0.05或P<0.01),除BUN外,DJC组的改善作用均优于西药组(P<0.05或P<0.01);DJC组FPG、Hb A1c明显降低(P<0.05或P<0.01),而西药组无明显变化(P>0.05)。Spearman相关分析结果显示,IL-18与Cys C存在相关性;IL-18、Cys C与Hb A1c、m Alb、UACR存在相关性。【结论】丹蛭降糖胶囊可保护糖尿病肾病早期患者的肾功能。
【Objective】 To observe the effect of Danzhijiangtang Capsule on the serum levels of interleukin 18 (IL-18), cystatin C (Cys C) and related indexes in the early stage of diabetic nephropathy (DKD) The protective effect. 【Methods】 Sixty-two patients with early diabetic nephropathy hospitalized in Department of Endocrinology, the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were enrolled. They were divided into western medicine group and Danzhijiangtang capsule group (referred to as DJC group), with 31 cases in each group. Western medicine group given conventional hypoglycemic agents and benazepril treatment, DJC group on the basis of western medicine group given oral Danzhi Jiangtang capsule. The levels of serum IL-18, Cys C, fasting plasma glucose (FPG), postprandial 2h PG, Hb A1c, SCr, BUN, (M Alb), urinary albumin creatinine ratio (UACR), glomerular filtration rate (e GFR) expression levels. 【Results】 The total effective rate was 90.0% in DJC group and 76.7% in western medicine group. The effect of DJC group was better than western medicine group (P <0.05). After treatment, the scores of major TCM syndromes in DJC group decreased significantly compared with that before treatment, and their improvement was better than western medicine group (P <0.05 or P <0.01). After treatment, the serum levels of IL-18, Cys C, 2h PG, SCr, BUN, m ALB and UACR in both groups were significantly lower than those before treatment (P <0.05 or P < 0.01). In addition to BUN, the improvement of DJC group was better than Western medicine group (P <0.05 or P <0.01); FPG and Hb A1c in DJC group were significantly lower than those in western medicine group (P <0.05 or P <0.01) Change (P> 0.05). Spearman correlation analysis showed that there was a correlation between IL-18 and Cys C; there was a correlation between IL-18, Cys C and Hb A1c, m Alb, UACR. 【Conclusion】 Danzhi Jiangtang Capsule can protect renal function of patients with early stage of diabetic nephropathy.