丹蛭降糖胶囊对早期糖尿病肾病患者血NF-κB和尿白蛋白排泄率的影响

摘要

This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on NF-κB in the peripheral blood mononuclear cell , and inflammation indices such as serum MCP-1 , TGF-β1 and urinary albu-min excretion rate ( UAER ) in early diabetic nephropathy ( EDN ) , in order to discuss the possible mechanism of DJC on anti-inflammatory and renal protection effect of EDN. A total of 72 EDN patients which met the in-clusion criteria after the start-up stage were taken as research objects . They were randomly divided into the control group and the treatment group. The western comprehensive treatment plan was given to both groups. In the treatment group, DJC was added. And the treatment course was 8 weeks. Changes of MCP-1, NF-κB, TGF-β1 and UAER were observed before and after the treatment . The results showed that MCP-1 , NF-κB and TGF-β1 had significant positive correlation with UAER ( P < 0 . 05 , or P < 0 . 01 ) . Compared to pre-treat- ment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER in the control group and treatment group after treat-ment were significantly declined ( P < 0 . 05 ) . Compared with the control group , after treatment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER of the treatment group were obviously reduced ( P < 0 . 05 , or P <0 . 01 ) . It was concluded that DJC can reduce the UAER , delay the renal injury , and downregulate levels of MCP-1, NF-κB and TGF-β1, block the expression of inflammatory mediators, inhibit inflammatory reaction and improve microinflammatory state of EDN. This may be one of the important mechanisms in the protection of renal function .%目的：观察丹蛭降糖胶囊对早期糖尿病肾病（EDN）患者外周血单个核细胞中核转录因子（NF-资B）和血清MCP-1，TGF-β1等炎症指标及尿白蛋白排泄率（UAER）的影响，探讨丹蛭降糖胶囊对EDN抗炎作用及肾保护的可能机制。方法：以导入期后符合纳入标准的72例EDN患者为研究对象，随机分为对照组和治疗组。2组均采用以缬沙坦为基础的西医综合治疗方案，治疗组在此基础上加用丹蛭降糖胶囊，2组疗程均为8周。观察治疗前后MCP-1，NF-资B，TGF-β1及UAER的变化。结果：MCP-1，NF-资B及TGF-β1与UAER呈显著正相关（P<0.05或P<0.01），与治疗前比较，对照组与治疗组治疗后MCP-1， NF-资B，TGF-β1及UAER均明显下降（P<0.05），与对照组比较，治疗组治疗后MCP-1，NF-资B，TGF-β1及UAER均明显降低（P<0.05或P<0.01）。结论：丹蛭降糖胶囊可降低尿白蛋白排泄率，延缓肾脏损伤，从而下调患者血MCP-1，NF-资B及TGF-β1的水平，阻断炎症介质的表达，抑制炎症反应，改善EDN微炎症状态，可能是其保护肾脏功能的重要机制之一。