张晓丽, 张金梅, 武文斌, 蔡国梅, 陈玲玲. 肾炎舒颗粒对早期糖尿病肾脏疾病患者氧化应激及蛋白尿的影响[J]. 临床肾脏病杂志, 2018, 18(10): 606-610. DOI: 10.3969/j.issn.1671-2390.2018.10.004
    引用本文: 张晓丽, 张金梅, 武文斌, 蔡国梅, 陈玲玲. 肾炎舒颗粒对早期糖尿病肾脏疾病患者氧化应激及蛋白尿的影响[J]. 临床肾脏病杂志, 2018, 18(10): 606-610. DOI: 10.3969/j.issn.1671-2390.2018.10.004
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    ZHANG Xiao-li, ZHANG Jin-mei, WU Wen-bin, CAI Guo-mei, CHEN Ling-ling. Effect of Shenyanshu granules on oxidative stress and albuminuria in patients with early diabetic kidney disease[J]. Journal of Clinical Nephrology, 2018, 18(10): 606-610. DOI: 10.3969/j.issn.1671-2390.2018.10.004
    Citation: ZHANG Xiao-li, ZHANG Jin-mei, WU Wen-bin, CAI Guo-mei, CHEN Ling-ling. Effect of Shenyanshu granules on oxidative stress and albuminuria in patients with early diabetic kidney disease[J]. Journal of Clinical Nephrology, 2018, 18(10): 606-610. DOI: 10.3969/j.issn.1671-2390.2018.10.004
    shu

    肾炎舒颗粒对早期糖尿病肾脏疾病患者氧化应激及蛋白尿的影响

    Effect of Shenyanshu granules on oxidative stress and albuminuria in patients with early diabetic kidney disease

      摘要
    • 摘要: 目的 观察肾炎舒颗粒对早期糖尿病肾脏疾病患者治疗前后氧化应激及蛋白尿的变化情况，以探索其抗蛋白尿的部分机制。方法 选取2013年2月-2015年7月于潍坊医学院附属益都中心医院肾脏内科住院的78例早期糖尿病肾脏疾病患者为研究对象，运用随机数字表将患者随机分为对照组（n=40）及观察组（n=38）。两组均予以饮食控制、降血脂、血管紧张素转化酶抑制剂等基础治疗的同时，给予糖尿病常规胰岛素治疗。观察组在此基础上给予肾炎舒颗粒口服，5 g/次，tid。两组患者分别于治疗前及治疗6个月后监测尿液中蛋白/肌酐比值、足细胞顶端膜性蛋白/肌酐比值、白蛋白/肌酐比值、免疫球蛋白G/肌酐比值，同时抽血检测血清超氧化物歧化酶活性、丙二醛的含量。结果 治疗6个月后，观察组血清超氧化物歧化酶较治疗前极显著升高（P<0.01），较对照组显著升高（P<0.05）；丙二醛较治疗前极显著降低（P<0.01），较对照组显著降低（P<0.05）；观察组尿足细胞顶端膜性蛋白/肌酐比值、白蛋白/肌酐比值较治疗前及对照组均有明显降低（P<0.01）；但观察组尿蛋白/肌酐比值、免疫球蛋白G/肌酐比值治疗前后及与对照组比较无变化。结论 肾炎舒颗粒可减少早期糖尿病肾脏疾病患者的蛋白尿，其机制可能与通过抗氧化应激对足细胞的顶端膜蛋白进行保护有关。

       

      Abstract: Objective To understand the mechanism of the anti-protein urine through observing the changes of oxidative stress and albuminuria in patients with early diabetic kidney disease before and after treatment. Methods A total of 78 patients with early diabetic kidney disease who were hospitalized in the Department of Nephrology at Yidu Central Hospital affiliated to Weifang medical college from February 2013 to July 2015 were selected as the study subjects. They were divided into the control group (n=40) and the observation group (n=38) using a random number table. Both groups were given basic treatment such as dietary control, hypolipidemic and angiotensin-converting enzyme inhibitors (ACEI), and given routine insulin therapy for diabetes. The patients in the observation group took 5 g Shenyanshu granules each time, 3 times a day. The value of urinary protein creatinine ratio (PRO/Cr), podocyte apical membrane Podocalyxin protein to creatinine ratio (PCX/Cr), albumin creatinine ratio (Alb/Cr), immunoglobulin G creatinine ratio (IgG/Cr), the activity of superoxide dismutase (SOD), and the content of malondialdehyde (MDA) in two groups were monitored before and 6 months after treatment, respectively. Results After 6 months of treatment, the SOD activity in the observation group was significantly greater than that before treatment (P<0.01) and the control group (P<0.05). MDA content after treatment in the observation group was significantly lower than before treatment (P<0.01). As compared with the control group, MDA content in the observation group decreased (P<0.05). Urinary PCX/Cr and Alb/Cr after treatment in the observation group were significantly lower than before treatment and control group (P<0.01). There was no significant change in urine PRO/Cr and IgG/Cr in two groups before and after treatment. Conclusions Shenyanshu granules can reduce albuminuria in patients with early diabetic kidney disease, which may be related with the protecting effect of oxidative stress on podocyte apical membrane protein PCX.

       

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