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目的:探讨益肾活血方对糖尿病肾病患者凝血功能、血浆内皮素-1(ET-1)、降钙素基因相关肽(CGRP)的影响,为治疗糖尿病肾病提供依据。方法:选择2010年2月—2015年3月在我院治疗的94例糖尿病肾病患者(气阴两虚兼瘀血),按治疗方法分为两组,对照组给予格列喹酮和诺和灵30R治疗,在对照组的基础上,研究组给予益肾活血方。治疗3月后,评价两组的临床疗效,对比治疗前后的肾功能、血糖、ET-1、CGRP、凝血功能,并观察在治疗过程中的不良反应。结果:(1)研究组总有效率为80.85%,高于对照组总有效率61.70%(P<0.05);(2)研究组治疗后的24 h尿微量蛋白、血肌酐、尿素氮、胱抑素c、同型半胱氨酸、空腹血糖、餐后2 h血糖、糖化血红蛋白较治疗前均出现减少(P均<0.05),且研究组治疗前后差值明显大于对照组的(P均<0.05);(3)两组治疗后的ET-1较治疗前均出现降低,CGRP较治疗前升高,差异显著(P均<0.05),且研究的ET-1、CGRP治疗前后差值明显大于对照组的,差异显著(P均<0.05);(4)两组治疗后的纤维蛋白原(FIB)较治疗前均出现降低,活化部分凝血活酶时间(APTT)较治疗前升高,差异显著(P均<0.05),且研究组的FIB、APTT治疗前后差值明显大于对照组的,差异显著(P均<0.05);(5)在治疗的过程中,两组均未出现不良反应。结论:益肾活血方对糖尿病肾病患者(气阴两虚兼瘀血)治疗效果较好,能有效地改善肾功能及血糖,这可能与调节凝血功能、血浆内皮素及降钙素基因相关肽有一定关系。
Objective: To investigate the effects of Yishenhuoxue Recipe on coagulation function, plasma endothelin-1 (ET-1) and calcitonin gene related peptide (CGRP) in patients with diabetic nephropathy and to provide evidence for the treatment of diabetic nephropathy. Methods: 94 patients with diabetic nephropathy (Qi-Yin Deficiency and Blood Stasis) treated in our hospital from February 2010 to March 2015 were divided into two groups according to the method of treatment. The patients in the control group were given gliquidone and Novo Ling 30R treatment, on the basis of the control group, the study group given Yishenhuoxue side. After 3 months of treatment, the clinical efficacy of the two groups was evaluated, and the renal function, blood glucose, ET-1, CGRP and coagulation function were compared before and after treatment, and the adverse reactions during the treatment were observed. Results: (1) The total effective rate was 80.85% in the study group, which was 61.70% (P <0.05) higher than that in the control group. (2) The 24-hour urinary microalbuminuria, serum creatinine, The levels of cTn, Hcy, fasting blood glucose, postprandial 2-h blood glucose and HbA1c decreased compared with those before treatment (all P <0.05), and the differences between before and after treatment in the study group were significantly greater than those in the control group (P < 0.05). (3) After treatment, both ET-1 and ET-1 decreased compared with those before treatment, CGRP increased significantly (P <0.05), and the difference between ET-1 and CGRP before and after treatment was significant (P <0.05). (4) Fibrinogen (FIB) decreased after treatment in both groups, APTT increased compared with that before treatment, (P <0.05), and the differences between before and after treatment of FIB and APTT in the study group were significantly greater than those in the control group (all P <0.05). (5) During the course of treatment, no difference was found between the two groups reaction. Conclusion: Yishenhuoxue decoction has a good effect on patients with diabetic nephropathy (Qi-Yin Deficiency and Blood Stasis) and can effectively improve renal function and blood sugar, which may be related to the regulation of blood coagulation, plasma endothelin and calcitonin gene related peptide Have a certain relationship.