世界中医药

目的：观察早期糖尿病肾病胰岛素抵抗情况、VEGF表达水平以及百令胶囊的干预治疗效应。方法:选取2014年12月至2016年12月内蒙古自治区人民医院收治的早期糖尿病肾病患者80例,随机分为对照组和观察组,每组40例,2组均接受控制血糖、调脂、控制血压、抗血小板聚集等综合治疗,观察组在上述基础治疗上加用百令胶囊,2组患者均以8周为疗程,治疗前后比较2组患者中医证候积分、血糖、血压、脂代谢、VEGF浓度变化情况。结果:1)治疗后2组患者中医证候积分均有所下降,其中观察组下降的趋势更为明显(P<0.05);2)治疗前2组脂代谢水平相仿,差异无统计学意义(P>0.05),经过治疗后2组患者TC、TG、LDL-C均较治疗前明显下降,差异有统计学意义(P<0.05),HDL-C水平有明显提升,差异有统计学意义(P<0.05),其中观察组改善的幅度较对照组明显,差异有统计学意义(P<0.05);3)百令胶囊可明显改善早期糖尿病肾病患者肾功能指标及胰岛素抵抗情况,与对照组比较差异有统计学意义(P<0.05);4)与对照组比较,百令胶囊更可明显下调早期糖尿病肾病机体VEGF的水平及足细胞数量,差异均有统计学意义(P<0.05)。结论:百令胶囊可明显纠正糖尿病肾病患者胰岛素抵抗现象,并进一步改善患者肾功能及脂代谢水平,其作用机制可能与下调VEGF有关。

English Summary:

To observe the insulin resistance, VEGF expression level of early diabetic nephropathy and the therapeutic intervention effects of Bailing capsule. Methods: A total of 80 patients with early diabetic nephropathy in our hospital from December 2014 to December 2016 were included in the study. They were randomly divided into control group and observation group, 40 cases in each group. Both of two groups received the comprehensive treatment of blood glucose control, lipid regulation, blood pressure control, antiplatelet aggregation and so on. While patients in the observation group additionally took bailing capsule on the basis of treatment above-mentioned. The two groups of patients both had 8 weeks for a treatment course. The changes of TCM syndrome integral, blood glucose, blood pressure, lipid metabolism and VEGF concentration of two groups were compared before and after the treatment. Results: 1) TCM syndrome integrals decreased both in two groups after treatment, the downward trend in the observation group was more obvious (P<0.05); 2) The lipid metabolism levels of two groups were similar before treatment and there was no statistically significant difference (P>0.05). The TC, TG, LDL-C of two groups significantly decreased after treatment and the differences were statistical significant (P<0.05). The HDL-C level significantly increased and the differences were statistical significant (P<0.05). Besides, the improvement range of the observation group was more obviously than the control group and the differences were statistically significant (P<0.05). 3) Bailing capsule could obviously improve the renal function indexes and insulin resistance of patients with early diabetic nephropathy and there were statistically significant differences compared with the control group (P<0.05). 4) Compared with the control group, Bailing capsule could obviously lower the levels of VEGF and podocyte number in early diabetic nephropathy of the body and the differences were statistically significant (P<0.05). Conclusion: Bailing capsule can obviously correct insulin resistance of diabetic nephropathy patients, and further improve patients' renal function and lipid metabolism, and its mechanism may associated with the down-regulation of VEGF.

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