Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy

Ya-lan HUANG; Guo-dong HUANG; Lin-kun CAI; Jia-li GAN; Han-yu XUE; Qiong-he HUANG

doi:10.13422/j.cnki.syfjx.20200425

您当前的位置：

首页 >

文章列表页 >

Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 5, Pages: 60-68(2020)
- 作者机构：
  
  1.广西中医药大学，南宁　 530001
  2.广西中医药大学　附属国际壮医医院，南宁　 530201
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200425
  CLC： R22; R242; R2-031;R287;R587.2
- Received：09 August 2019，
  
  Published Online：04 November 2019，
  
  Published：05 March 2020
- 稿件说明：
移动端阅览
Ya-lan HUANG, Guo-dong HUANG, Lin-kun CAI, et al. Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 60-68.
DOI：

Ya-lan HUANG, Guo-dong HUANG, Lin-kun CAI, et al. Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 60-68. DOI： 10.13422/j.cnki.syfjx.20200425.

摘要

目的：

观察补阳还五汤合三仁汤加减治疗早期糖尿病肾病(DN)脾肾亏虚兼湿热瘀血证的临床疗效及对糖脂代谢、氧化应激、炎症因子的影响，并探讨其作用机制。

方法：

将72例患者按随机数字表法分为对照组与治疗组，各36例。在常规治疗基础上，对照组口服氯沙坦钾片，50 mg/次，1次/d。治疗组在对照组治疗的基础上给予补阳还五汤合三仁汤加减内服，1剂/d。两组疗程均为连续治疗3个月。观察两组患者临床疗效，比较两组患者治疗前后24 h尿微量白蛋白排泄率(UAER)，血肌酐(SCr)，血清胱抑素C(Cys C)，尿素氮(BUN)，空腹血糖(FBG)，餐后2 h血糖(2 hPG)，糖化血红蛋白(HbA1c)，总胆固醇(TC)，甘油三酯(TG)，低密度脂蛋白胆固醇(LDL-C)，高密度脂蛋白胆固醇(HDL-C)，丙二醛(MDA)，超氧化物歧化酶(SOD)，谷胱甘肽过氧化物酶(GSH-Px)，白细胞介素-2(IL-2)，白细胞介素-4(IL-4)，白细胞介素-8(IL-8)，白细胞介素-10(IL-10)，肿瘤坏死因子-

(TNF-

)水平和安全性指标。

结果：

治疗组临床总有效率为88.9%，对照组61.1%，治疗组优于对照组(

0.05)。两组治疗后UAER，SCr，Cys C，BUN水平较本组治疗前均降低(

0.05)；且治疗组均明显低于对照组(

0.05)。两组治疗后FBG，2 hPG和HbA1c水平较本组治疗前均降低(

0.05)；治疗后与对照组比较，两组FBG，2 hPG和HbA1c水平比较差异无统计学意义。两组治疗后HDL-C水平较本组治疗前均升高(

0.05)；且治疗组明显高于对照组(

0.05)。两组治疗后TC，TG和LDL-C，MDA水平较本组治疗前均降低(

0.05)；且治疗组均明显低于对照组(

0.05)。两组治疗后MDA水平较本组治疗前均降低(

0.05)；且治疗组明显低于对照组(

0.05)。两组治疗后血清IL-2，IL-8和TNF-

水平较本组治疗前均降低(

0.05)；且治疗组均明显低于对照组(

0.05)。两组治疗后血清IL-4和IL-10水平较本组治疗前均升高(

0.05)；且治疗组均明显高于对照组(

0.05)。

结论：

补阳还五汤合三仁汤加减治疗早期DN脾肾亏虚兼湿热瘀血证的临床疗效显著且安全性好，能够进一步改善早期DN患者的肾功能、脂质代谢，抑制氧化应激反应及调节炎症因子分泌平衡。

Abstract

Objective:

To observe the clinical efficacy of modified Buyang Huanwu Tang combined with Sanrentang in treating early diabetic nephropathy(DN)with deficiency of spleen and kidney

damp-heat and blood stasis syndrome and its effect on glucose and lipid metabolism

oxidative stress and inflammatory factors

in order to explore its mechanism.

Method:

A total of 72 early DN atients were randomly divided into control group and treatment group

with 36 cases in each group. The control group was orally treated with losartan potassium tablets(50 mg every time

once/day)

while the treatment group was treated with modified Buyang Huanwu Tang combined with Sanrentang orally in addition to the therapy of the control group(1 dose/day). Both groups were treated for 3 months. The changes in clinical efficacy and safety indicators were observed for both groups. The 24 h urine albumin excretion rate(UAER)

serum creatinine(SCr)

serum cystatin C(Cys C)

urea nitrogen (BUN)

fasting blood glucose (FBG)

2 h postprandial blood glucose (2 hPG)

glycosylated hemoglobin (HbA1c)

total cholesterol (TC)

triglyceride(TG)

low-density lipoprotein cholesterol(LDL-C)

high-density lipoprotein cholesterol(HDL-C)

malondialdehyde(MDA)

superoxide dismutase(SOD)

glutathione Peroxidase(GSH-Px)

interleukin-2(IL-2)

interleukin-4(IL-4)

interleukin-8(IL-8)

interleukin-10(IL-10)

tumor necrosis factor-

(TNF-

)of patients in two groups were observed before and after treatment.

Result:

The total clinical effective rate was 88.9%in therapy group

which was higher than 61.1%in control group(

0.05). After treatment

levels of UAER

SCr

Cys C and BUN were lower in both groups(

0.05)

and the levels in treatment group were all lower than those in control group(

0.05). Levels of FBG

2 hPG and HbA1c were lower in both groups(

0.05). There was no significant difference in FBG

2 hPG and HbA1c levels between two groups after treatment. The levels of HDL-C were higher in both groups(

0.05)

and the levels in treatment group were higher than that in control group(

0.05). The levels of TC

TG and LDL-C were lower in both groups(

0.05)

and the levels in treatment group were all lower than those in control group(

0.05). The level of MDA was lower in both groups(

0.05)

and the level in the treatment group was lower than that in control group(

0.05). The levels of SOD and GSH-Px were higher in both groups(

0.05)

and the levels in the treatment group were all higher than those in the control group(

0.05). Serum levels of IL-2

IL-8 and TNF-

were lower in both groups(

0.05)

and the levels in the treatment group were lower than those in control group(

0.05). Serum levels of IL-4 and IL-10 were higher in both groups(

0.05)

and the levels in the treatment group was higher than those in control group(

0.05).

Conclusion:

Modified Buyang Huanwu Tang combined with Sanrentang is effective and safe in the treatment of early DN with spleen and kidney deficiency

damp-heat and blood stasis syndrome. They can further improve renal function and lipid metabolism

inhibit oxidative stress reaction and regulate the secretion balance of inflammatory factors in early DN patients.

关键词

Keywords

references

KDOQI . KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease [J]. Am J Kidney Dis ， 2007 ， 49 ( Suppl2 ): S12 - 154 .

T CAI , X Y WU , X Q ZHANG ， et al . Calcium dobesilate prevents diabetic kidney disease by decreasing bim and inhibiting apoptosis of renal proximal tubular epithelial cells [J]. DNA Cell Biol ， 2017 ， 36 ( 4 ): 249 - 255 .

李敏州，高彦彬，马鸣飞，等．糖尿病肾病发病机制研究进展 [J]．中国实验方剂学杂志， 2012 ， 18 ( 22 ): 344 - 349 .

林子桐，张超，沈雪梅．糖尿病肾病发病机制研究进展 [J]．中国药理学与毒理学杂志， 2014 ， 28 ( 5 ): 765 - 773 .

O LENZ , A FORNONI , A IJAZ ， et al . Role of inflammation in diabetic nephropathy [J]. Curr Diabetes Rev ， 2008 ， 4 ( 1 ): 10 - 17 .

I WAKABAYASHI , H MASUDA ． Association of D -dimer with microalbuminuria in patients with type 2 diabetes mellitus [J]. J Thromb Thrombolysis , 2009 , 27 ( 1 ): 29 - 35 .

H YOKOYAMA , S I ARAKI , J HONJO ， et al . Association between remission of macroalbuminuria and preservation of renal function in patients with type 2 diabetes with overt proteinuria [J]. Diabetes Care ， 2013 ， 36 ( 10 ): 3227 - 3233 .

L ZHANG , J LONG , W JIANG ， et al . Trends in chronic kidney disease in China [J]． N Engl J Med ， 2016 ， 375 ( 9 ): 905 - 906 .

H LI , B OLDENBURG , C CHAMBERLAIN , et al . Diabetes prevalence and determinantsin adults in China mainland from 2000 to 2010：a systematic review [J]． Diabetes Res Clin Pract , 2012 ， 98 ( 2 ): 226 - 235 .

许倬，涂晓文，曹海丽．糖尿病肾病治疗临床试验的研究进展 [J]．中国全科医学， 2017 ， 20 ( 20 ): 2535 - 2538 .

白宇，贺云，杨丽霞．活血化瘀类中药治疗糖尿病肾病机制的研究进展 [J]．中国实验方剂学杂志， 2018 ， 24 ( 23 ): 200 - 206 .

张萌佳，张洁．糖尿病肾病中医药临床研究进展 [J]．中国实验方剂学杂志， 2009 ， 15 ( 7 ): 95 - 97 .

陆世龙，王龙龙，黄国东．中医药治疗早期糖尿病肾病的研究进展 [J]．辽宁中医杂志， 2016 ， 43 ( 5 ): 1101 - 1103 .

黄雅兰，黄国东，甘佳丽，等．补阳还五汤联合RAAS阻断剂治疗早期糖尿病肾病疗效的Meta分析 [J]．辽宁中医杂志， 2019 ， 46 ( 7 ): 1362 - 1367 .

黄国东，陆世龙，庞宗然．补阳还五汤合三仁汤加减对早期糖尿病肾病的影响研究 [J]．中国现代医学杂志， 2016 ， 26 ( 24 ): 66 - 71 .

A D ASSOCIATION ． Standards of medical care in diabetes-2014 [J]． Diabetes Care ， 2013 ， 36 ( Suppl 1 ): S11 - S66 .

杨霓芝，刘旭生．糖尿病肾病诊断、辨证分型及疗效评定标准(试行方案) [J]．上海中医药杂志， 2007 ( 7 ): 7 - 8 .

中华人民共国卫生部．中药新药临床研究指导原则 [M]．北京：中国医药科技出版社， 2002 ： 1 - 392 .

中华人民共国卫生部．中药新药治疗慢性肾小球肾炎的临床研究指导原则 [M]. 1993 ： 133 - 136 .

尤良震，林逸轩，方朝晖，等．黄芪甲苷治疗糖尿病及其并发症药理作用研究进展 [J]．中国中药杂志， 2017 ， 42 ( 24 ): 4700 - 4706 .

陈素枝，檀金川．黄芪甲苷保护肾脏的分子机制研究进展 [J]．中草药， 2018 ， 49 ( 24 ): 5973 - 5979 .

刘雨晴，梁婧，杨梓晨，等．薏苡仁的药理作用研究进展 [J]．安徽农业科学， 2010 ， 38 ( 20 ): 10678 ， 10686 .

刘帆，侯林，张晓平，等．薏苡仁多糖抗肿瘤作用及免疫作用研究进展 [J]．辽宁中医药大学学报， 2019 ， 21 ( 3 ): 123 - 126 .

赵锦慧，赖颖，胡春红．八仙草提取物对两种常见致病菌的抑制效果 [J]．时珍国医国药， 2013 ， 24 ( 2 ): 390 - 391 .

封宽德．八仙复肝汤治疗肝源性糖尿病探讨 [J]．中国社区医师， 2008 ( 22 ): 44 .

李曦，张丽宏，王晓晓，等．当归化学成分及药理作用研究进展 [J]．中药材， 2013 ， 36 ( 6 ): 1023 - 1028 .

万晓青，张伟．当归对血液系统的药理作用研究进展 [J]．中草药， 2009 ， 40 ( 12 ): 2018 - 2020 .

陆小华，马骁，王建，等．赤芍的化学成分和药理作用研究进展 [J]．中草药， 2015 ， 46 ( 4 ): 595 - 602 .

王瑞，鲁岚，李颖伟，等．赤芍与白芍的药理作用比较 [J]．中国实验方剂学杂志， 2010 ， 16 ( 7 ): 112 - 114 .

李海刚，胡晒平，周意，等．川芎主要药理活性成分药理研究进展 [J]．中国临床药理学与治疗学， 2018 ， 23 ( 11 ): 1302 - 1308 .

谭亮，汤秋凯，王守章，等．三七皂苷R 1 药理作用的研究进展 [J]．中国药理学通报， 2018 ， 34 ( 5 ): 604 - 607 .

杨娟，袁一怔，尉广飞，等．三七植物化学成分及药理作用研究进展 [J]．世界科学技术—中医药现代化， 2017 ， 19 ( 10 ): 1641 - 1647 .

王亦君，冯舒涵，程锦堂，等．大黄蒽醌类化学成分和药理作用研究进展 [J]．中国实验方剂学杂志， 2018 ， 24 ( 13 ): 227 - 234 .

魏江存，陈勇，谢臻，等．中药大黄炮制品的化学成分及药效研究进展 [J]．中国药房， 2017 ， 28 ( 25 ): 3569 - 3574 .

高雪岩，王文全，魏胜利，等．甘草及其活性成分的药理活性研究进展 [J]．中国中药杂志， 2009 ， 34 ( 21 ): 2695 - 2700 .

吕萌，胡高云，涂志军，等．糖尿病肾病的发病机制及抗糖尿病肾病化合物的研究进展 [J]．中国新药杂志， 2014 ， 23 ( 10 ): 1139 - 1145 .

刘浩，姜迎萍，李凯利，等．血糖波动与糖尿病肾病氧化应激的相关性 [J]．中国老年学杂志， 2011 ， 31 ( 16 ): 3045 - 3046 .

闫寒，马博清，付彩雯．糖尿病肾病发病机制研究进展 [J]．中国老年学杂志， 2015 ， 35 ( 20 ): 5973 - 5975 .

陈小永，宋军营，王自闯 . 炎症和氧化应激在糖尿病肾病中的作用 [J]．中国老年学杂志， 2017 ， 37 ( 24 ): 6254 - 6256 .

朱玲娜，唐丽琴．糖尿病肾病中氧化应激对炎症细胞因子的影响 [J]．安徽医药， 2012 ， 16 ( 9 ): 1226 - 1229 .

K H JEONG , T W LEE , C G IHM ， et al . Effects of sildenafil on oxidative and inflammatory injuries of the kidney in streptozotocin-induced diabetic rats [J]. Am J Nephrol , 2009 , 29 ( 3 ): 274 - 282 .

张洁，董闪闪，康岩，等 . 2型糖尿病肾病患者血糖波动与氧化应激的相关性研究 [J]．中国全科医学， 2013 ， 16 ( 35 ): 3410 - 3413 .

干军，冯雨，徐宽枫，等．血清氧化应激指标与早期糖尿病肾病及代谢综合征的关系 [J]．临床荟萃， 2007 ( 14 ): 998 - 1000 .

A A ELMARAKBY , J C SULLIVAN . Relationship between oxidative stress and inflammatory cytokines in diabetic nephropathy [J]. Cardiovasc Ther , 2012 , 30 ( 1 ): 49 - 59 .

E CABISCOL , J TAMARIT , J ROS . Oxidative stress in bacteria and protein damage by reactive oxygen species [J]. Int Microbiol , 2000 , 3 ( 1 ): 3 - 8 .

毛志敏，黄燕如，万毅刚，等．糖尿病肾病肾组织氧化应激的调控机制及中药的干预作用 [J]．中国中药杂志， 2014 ， 39 ( 19 ): 3707 - 3712 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Metabonomic Analysis of Wenfei Huaxian Granules Against Idiopathic Pulmonary Fibrosis in Mice

Effect of Gegen Qinliantang-medicated Serum on Nonalcoholic Steatohepatitis Based on Nrf2/TXNIP Signaling Pathway

Protective Effect of Xiangsha Yuyang Decoction on Oxidative Injury in Rats with Gastric Ulcer Based on p62/Keap1/Nrf2 Signal Pathway

Intervention of Shenma Yizhi Prescription on Learning and Memory in Rats with Vascular Cognitive Impairment Induced by Chronic Cerebral Ischemia

Effect of Modified Buyang Huanwu Tang on Patients with Lumbar Disc Herniation After Percutaneous Foramen Endoscopy Based on Collateral Disease Theory

Related Author

LI Shanshan

HUANG Jun

LI Longxue

LI Shaofeng

ZHANG Cheng

YU Xiao

ZHANG Yuanbing

WEI Yue

Related Institution

Laboratory Animal Science and Technology Center，School of Traditional Chinese Medicine， School of Pharmacy，Jiangxi University of Chinese Medicine

The Affiliated Hospital of Jiangxi University of Chinese Medicine

Research Center for Traditional Chinese Medicine Resources and Ethnic Minority Medicine， Laboratory Animal Science and Technology Center，School of Pharmacy， Jiangxi University of Chinese Medicine

School of Life Sciences，Nanchang University

Henan University of Chinese Medicine

AI问答

Postal code：100700
Tel：010-84076882 Email：syfjx_2010@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备11006657号-10 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰