益肾方联合常规西药治疗糖尿病肾病临床研究

Clinical Study on Yishen Prescription Combined with Conventional Western Medicine for Diabetic Kidney Disease

摘要:

目的：观察益肾方联合常规西药治疗糖尿病肾病（DKD） 的临床疗效。方法：选取2022年6月—2025年6月广州中医药大学东莞医院收治的120例DKD患者，按照区组随机化分为对照组和观察组各60例。对照组采用常规西药治疗，观察组在对照组基础上加用益肾方治疗。2组均持续治疗8周。评价2组临床疗效，比较2 组治疗前后中医证候积分、肾功能、血清NOD 样受体蛋白3 （NLRP3）、哺乳动物雷帕霉素靶蛋白（mTOR） 水平。结果：观察组总有效率为96.67%（58/60），高于对照组81.67%（49/60）（P＜0.05）。治疗后，2组中医证候主症评分、次症评分较治疗前降低（P＜0.05），且观察组中医证候主症评分、次症评分低于对照组（P＜0.05）。治疗后，2组血尿素氮（BUN）、血肌酐（SCr） 及尿白蛋白排泄率（UAER） 较治疗前降低（P＜0.05），且观察组BUN、SCr及UAER低于对照组（P＜0.05）。治疗后，2组血清白细胞介素-6（IL-6）、肿瘤坏死因子-α （TNF-α）、NLRP3、mTOR 水平较治疗前降低（P＜0.05），且观察组血清IL-6、TNF-α、NLRP3、mTOR水平低于对照组（P＜0.05）。结论：益肾方联合常规西药治疗DKD患者的临床疗效较好，可改善肾功能，减轻炎症反应，下调血清NLRP3、mTOR表达水平。

Abstract:

Abstract： Objective： To observe the clinical efficacy of the combination use of Yishen Prescription and conventional western medicine on diabetic kidney disease （DKD）. Methods：A total of 120 DKD patients admitted to Dongguan Hospital， Guangzhou University of Chinese Medicine from June 2022 to June 2025 were randomly divided into the control group and the observation group using the block randomization，with 60 cases in each group. The control group was treated with conventional western medicine，and the observation group was additionally treated with Yishen Prescription based on the treatment in the control group. Both groups were treated for eight weeks. The clinical efficacy was evaluated， and the changes in traditional Chinese medicine syndrome scores， renal function， serum levels of NOD-like receptor protein 3 （NLRP3），and mammalian target of rapamycin （mTOR） were compared before and after treatment between the two groups. Results： The total effective rate was 96.67% （58/60） in the observation group， higher than that of 81.67% （49/60） in the control group （P＜0.05）. After treatment，the scores of main symptoms and secondary symptoms of traditional Chinese medicine syndromes in the two groups were decreased when compared with those before treatment （P＜0.05），and the above scores in the observation group were lower than those in the control group （P＜0.05）. After treatment， the levels of blood urea nitrogen （BUN）， serum creatinine （SCr）， and urinary albumin excretion rate （UAER） in the two groups were decreased when compared with those before treatment （P＜ 0.05）， and the levels of BUN， SCr， and UAER in the observation group were lower than those in the control group （P＜0.05）. After treatment， the levels of serum interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， NLRP3，and mTOR in the two groups were reduced when compared with those before treatment （P＜0.05），and the levels of serum IL-6， TNF- α， NLRP3， and mTOR in the observation group were lower than those in the control group（ P＜0.05）. Conclusion：The therapy of Yishen Prescription combined with conventional western medicine has a good clinical effect on DKD patients，which can improve the renal function，reduce the inflammatory responses，and down-regulate the expression levels of serum NLRP3 and mTOR.