糖肾康颗粒对糖尿病肾脏疾病气阴两虚血瘀证患者尿α- actinin- 4、Synaptopodin的影响
Effect of Tangshenkang Granule on Urinary α- Actinin- 4 and Synaptopodin in Patients with Diabetic Kidney Disease with Deficiency of Both Qi and Yin
  
DOI:
中文关键词:  糖尿病肾脏疾病  糖肾康颗粒  气阴两虚血瘀证  α- actinin- 4、Synaptopodin
英文关键词:Diabetic kidney disease  Tangshenkang Granule  Deficiency of both Qi and Yin  α- Actinin- 4  Synaptopodin
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作者单位
胡顺金,郑婷婷,曹媛茹,金 华,王 东,魏 玲,胡 岚,牛云飞 1.安徽中医药大学第一附属医院安徽 合肥 2300312.安徽中医药大学研究生院安徽 合肥 2300123.安徽中医药大学第三附属医院安徽 合肥 230031 
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中文摘要:
      目的 观察糖尿病肾脏疾病(diabetic kidney disease, DKD)气阴两虚血瘀证患者尿α- 肌动蛋白- 4(α- actinin- 4)、突触孔蛋白(Synaptopodin)水平的变化及糖肾康颗粒的干预作用。方法 将70例符合纳入标准的DKD气阴两虚血瘀证患者随机分为糖肾康组、对照组各35例。最终实际完成64例,其中糖肾康组33例,对照组31例,并另设正常组20例。两组患者均予常规治疗,糖肾康组同时予以糖肾康颗粒冲服,疗程均为8周。检测两组患者治疗前后估算肾小球滤过率(estimated glomerular filtrate rate,eGFR)、尿白蛋白肌酐比值(urinary albumin creatinine ratio,UACR)、24 h尿蛋白定量(24- hour urine protein,24hUP)、尿α- actinin- 4、尿Synaptopodin、血清肌酐(serum creatine, SCr)、血尿素氮(blood urea nitrogen, BUN)、空腹血糖(fasting plasma glucose, FPG)、餐后2 h血糖(2- hour plasma glucose,2hPG)及糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平,并观察中医证候积分值的变化。结果 糖肾康组患者临床疗效显著优于对照组(P<0.05)。两组患者证候积分值均随疗程增加而降低(P<0.05),且糖肾康组积分下降幅度均明显大于同期对照组(P<0.05)。治疗后,两组患者UACR、24hUP均显著下降(P<0.05),且糖肾康组均较同期对照组下降更为显著(P<0.05)。两组患者治疗前后BUN、SCr、eGFR、FPG、2hPG及HbA1c水平比较,差异均无统计学意义(P>0.05)。治疗前,两组患者尿α- actinin- 4、Synaptopodin水平均明显高于正常组(P<0.05)。治疗后,糖肾康组尿α- actinin- 4、Synaptopodin水平均明显下降(P<0.05);而对照组尿α- actinin- 4、Synaptopodin水平与治疗前比较,差异均无统计学意义(P>0.05)。结论 糖肾康颗粒可明显改善DKD气阴两虚血瘀证患者的临床症状,降低尿蛋白,其作用机制可能与降低尿α- actinin- 4、Synaptopodin水平有关。
英文摘要:
      Objective To investigate the changes in urinary α- actinin- 4 and Synaptopodin in patients with diabetic kidney disease (DKD) with deficiency of both Qi and Yin and the intervention effect of Tangshenkang Granule.Methods A total of 70 DKD patients with deficiency of both Qi and Yin who met the inclusion criteria were enrolled and randomly divided into Tangshenkang Granule group and control group,with 35 patients in each group.A total of 64 patients completed the treatment,with 33 in the Tangshenkang Granule group and 31 in the control group.A total of 20 healthy individuals were enrolled as normal group.The patients in the control group were given conventional treatment alone,and those in the Tangshenkang Granule group were given conventional treatment combined with Tangshenkang Granule;the course of treatment was 8 weeks for both groups.Related indices were measured for both groups, including urinary albumin creatinine ratio (UACR),24- hour urinary protein (24hUP), urinary α- actinin- 4,urinary Synaptopodin,serum creatine (SCr),blood urea nitrogen (BUN),fasting plasma glucose (FPG), 2- hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c),and the change in traditional Chinese medicine (TCM) syndrome score was evaluated. Results The Tangshenkang Granule group had a significantly better clinical outcome than the control group (P<0.05). Both groups had a significant reduction in TCM syndrome score over the course of treatment (P<0.05), and the Tangshenkang Granule group had a significantly greater reduction than the control group (P<0.05). Both groups had significant reductions in UACR and 24hUP after treatment (P<0.05), and the Tangshenkang Granule group had significantly greater reductions than the control group (P<0.05). There were no significant differences between the two groups in BUN, SCr, glomerular filtration rate, FPG, 2hPG, and HbA1c level before and after treatment (P>0.05). Before treatment, the Tangshenkang Granule group and the control group had significantly higher urinary levels of α- actinin- 4 and Synaptopodin than the normal group (P<0.05); after treatment, the Tangshenkang Granule group had significant reductions in urinary α- actinin- 4 and Synaptopodin (P<0.05), while there were no significant changes in urinary α- actinin- 4 and Synaptopodin in the control group (P>0.05). Conclusion Tangshenkang Granule can significantly improve the clinical symptoms of DKD patients with deficiency of both Qi and Yin and reduce urinary protein, possibly by reducing the urinary levels of α- actinin- 4 and Synaptopodin.
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