Objective:To evaluate the protective effect of Yiqi Qingre Xiaozheng formula(YQQRXZF)via the regulation of autophagy in diabetic nephropathy(DN)mice induced by injection of streptozotocin(STZ)after high fat diet(HFD)....Objective:To evaluate the protective effect of Yiqi Qingre Xiaozheng formula(YQQRXZF)via the regulation of autophagy in diabetic nephropathy(DN)mice induced by injection of streptozotocin(STZ)after high fat diet(HFD).Methods:The composition of YQQRXZF was analyzed by high performance liquid chromatographyelectrospray ionization/mass spectrometry(HPLC-ESI/MSn).The DN model was induced by intraperitoneally injection of 50 mg/kg STZ within 5 days,followed by HFD feeding for 8 weeks in C57BL/6J mice.Mice were randomly separated into DN group,YQQRXZF group,irbesartan group,and control group.Blood glucose was calculated,and body weight was measured every 2 weeks.An enzyme-linked immunosorbent assay was used to measure the urinary albumin-to-creatinine ratio(uACR)before and after treatment,and the serum concentrations of total cholesterol(TC),low-density lipoprotein(LDL),triglycerides(TG),high-density lipoprotein(HDL),blood urea nitrogen(BUN),and serum creatinine(Scr)were measured.In addition,hematoxylin-eosin(H&E)staining,periodic acid-Schiff(PAS)staining,Masson's trichrome staining,and transmission electron microscopy(TEM)were used to observe pathological changes in renal tissue.Autophagy levels were determined by immunofluorescence staining.Results:In this study,21 dominant chemical constituents were identified in YQQRXZF.The treatment group reduced u ACR in a more significant way than the DN group(P=.018).The treatment group reduced TC,TG,and LDL concentrations after YQQRXFF treatment(P=.021,P=.014 and P=.026,respectively).H&E,PAS,and Masson staining showed that pathological damage to mice kidneys improved,the volume of renal glomeruli was reduced,and glomerular sclerosis and fibrosis were reduced.Immunofluorescence analysis revealed that expressions of LC3-Ⅱprotein increased in the treatment group(P=.013).In contrast,the protein expressions of P62 were reduced after treatment(P=.025).展开更多
目的观察益气养阴消癥通络方联合西医基础疗法治疗Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证的临床疗效和安全性。方法采用随机、安慰剂对照、多中心研究方法。将323例Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证患者随机分为中药组...目的观察益气养阴消癥通络方联合西医基础疗法治疗Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证的临床疗效和安全性。方法采用随机、安慰剂对照、多中心研究方法。将323例Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证患者随机分为中药组163例和对照组160例。两组患者均给予西医基础治疗,中药组给予益气养阴消癥通络方口服,每日1剂,同时予厄贝沙坦安慰剂150 mg,每日1次;对照组给予厄贝沙坦片和中药安慰剂口服,服法同中药组。两组患者均治疗24个月。治疗前后进行实验室主要指标检测[包括尿微量白蛋白排泄率(UAER)、24小时尿蛋白定量(24 h UTP)、肾小球滤过率(GFR)、内生肌酐清除率(Ccr)和血肌酐(Scr)]、次要指标检测[包括糖化血红蛋白(HbA1c)和总胆固醇(TC)],治疗后判定实验室主要检测指标疗效,治疗前后进行中医证候评分并判定中医证候疗效,记录终点事件发生率,采用健康调查简表(SF-36)评价患者生活质量,观察不良反应。结果中药组实验室主要检测指标总有效率和中医证候疗效分别为67.84%、70.55%,对照组分别为46.88%、52.50%,两组差异均有统计学意义(P<0.01)。两组治疗后HbA1c、TC水平均显著低于治疗前(P<0.05或P<0.01)。SF-36量表各维度评分均显著高于治疗前,且治疗后中药组SF-36量表躯体疼痛、情感功能和精神健康维度评分显著高于对照组(P<0.05或P<0.01)。中药组终点事件发生率为8.51%,对照组为10.53%,两组差异无统计学意义(P>0.05);治疗前后未发现与试验药物有关的不良反应。结论益气养阴消癥通络方结合西医基础疗法治疗Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证可有效改善患者临床症状,降低尿蛋白,保护肾功能,提高患者生活质量,与对照药物厄贝沙坦比较,疗效更佳。展开更多
目的:探索清热消癥方在减少糖尿病肾脏疾病(DKD)患者蛋白尿方面的有效性和安全性,并对其疗效机制进行初步探索。方法:将符合本研究要求的60例DKD患者按1∶1随机分为对照组和试验组,每组30例,分别接受西医常规治疗、西医常规配合清热消...目的:探索清热消癥方在减少糖尿病肾脏疾病(DKD)患者蛋白尿方面的有效性和安全性,并对其疗效机制进行初步探索。方法:将符合本研究要求的60例DKD患者按1∶1随机分为对照组和试验组,每组30例,分别接受西医常规治疗、西医常规配合清热消癥方治疗,疗程共24周,以24 h尿蛋白(24 h UTP)为主要疗效指标,以肾功能[肾小球滤过率(eGFR)、血肌酐(Scr)、血尿素氮(BUN)]、内热积分及生活质量评分[躯体健康总分(PCS)和心理健康总分(MCS)]为次要疗效指标,检测患者治疗前后血清肿瘤坏死因子-α(TNF-α)和可溶性肿瘤坏死因子1、2型受体(sTNFR1、sTNFR2)水平,并进行安全性评价。结果:试验组患者24 h UTP的下降程度显著高于对照组(P<0.01)。试验组患者治疗前后的肾功能差异无统计学意义,而对照组患者Scr较治疗前显著升高(P<0.05)。试验组患者内热积分较治疗前显著降低、生活质量评分显著提高(P<0.05,P<0.01)。试验组患者治疗前后血清各炎症因子水平差异无统计学意义,而对照组患者血清sTNFR1水平较治疗前显著升高(P<0.05),且其增加程度显著高于试验组(P<0.05)。患者在试验期间未发生与药物直接相关的不良反应。结论:在西医常规治疗的基础上配合清热消癥方可以更为有效地改善DKD患者的蛋白尿,延缓肾功能进展,改善临床症状,提高生活质量,减轻炎症状态可能是其作用机制之一,然而其远期疗效仍需要进一步研究。展开更多
基金supported by the National Natural Science Foundation of China program(8187141391)。
文摘Objective:To evaluate the protective effect of Yiqi Qingre Xiaozheng formula(YQQRXZF)via the regulation of autophagy in diabetic nephropathy(DN)mice induced by injection of streptozotocin(STZ)after high fat diet(HFD).Methods:The composition of YQQRXZF was analyzed by high performance liquid chromatographyelectrospray ionization/mass spectrometry(HPLC-ESI/MSn).The DN model was induced by intraperitoneally injection of 50 mg/kg STZ within 5 days,followed by HFD feeding for 8 weeks in C57BL/6J mice.Mice were randomly separated into DN group,YQQRXZF group,irbesartan group,and control group.Blood glucose was calculated,and body weight was measured every 2 weeks.An enzyme-linked immunosorbent assay was used to measure the urinary albumin-to-creatinine ratio(uACR)before and after treatment,and the serum concentrations of total cholesterol(TC),low-density lipoprotein(LDL),triglycerides(TG),high-density lipoprotein(HDL),blood urea nitrogen(BUN),and serum creatinine(Scr)were measured.In addition,hematoxylin-eosin(H&E)staining,periodic acid-Schiff(PAS)staining,Masson's trichrome staining,and transmission electron microscopy(TEM)were used to observe pathological changes in renal tissue.Autophagy levels were determined by immunofluorescence staining.Results:In this study,21 dominant chemical constituents were identified in YQQRXZF.The treatment group reduced u ACR in a more significant way than the DN group(P=.018).The treatment group reduced TC,TG,and LDL concentrations after YQQRXFF treatment(P=.021,P=.014 and P=.026,respectively).H&E,PAS,and Masson staining showed that pathological damage to mice kidneys improved,the volume of renal glomeruli was reduced,and glomerular sclerosis and fibrosis were reduced.Immunofluorescence analysis revealed that expressions of LC3-Ⅱprotein increased in the treatment group(P=.013).In contrast,the protein expressions of P62 were reduced after treatment(P=.025).
文摘目的观察益气养阴消癥通络方联合西医基础疗法治疗Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证的临床疗效和安全性。方法采用随机、安慰剂对照、多中心研究方法。将323例Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证患者随机分为中药组163例和对照组160例。两组患者均给予西医基础治疗,中药组给予益气养阴消癥通络方口服,每日1剂,同时予厄贝沙坦安慰剂150 mg,每日1次;对照组给予厄贝沙坦片和中药安慰剂口服,服法同中药组。两组患者均治疗24个月。治疗前后进行实验室主要指标检测[包括尿微量白蛋白排泄率(UAER)、24小时尿蛋白定量(24 h UTP)、肾小球滤过率(GFR)、内生肌酐清除率(Ccr)和血肌酐(Scr)]、次要指标检测[包括糖化血红蛋白(HbA1c)和总胆固醇(TC)],治疗后判定实验室主要检测指标疗效,治疗前后进行中医证候评分并判定中医证候疗效,记录终点事件发生率,采用健康调查简表(SF-36)评价患者生活质量,观察不良反应。结果中药组实验室主要检测指标总有效率和中医证候疗效分别为67.84%、70.55%,对照组分别为46.88%、52.50%,两组差异均有统计学意义(P<0.01)。两组治疗后HbA1c、TC水平均显著低于治疗前(P<0.05或P<0.01)。SF-36量表各维度评分均显著高于治疗前,且治疗后中药组SF-36量表躯体疼痛、情感功能和精神健康维度评分显著高于对照组(P<0.05或P<0.01)。中药组终点事件发生率为8.51%,对照组为10.53%,两组差异无统计学意义(P>0.05);治疗前后未发现与试验药物有关的不良反应。结论益气养阴消癥通络方结合西医基础疗法治疗Ⅲ、Ⅳ期糖尿病肾病气阴两虚、络脉癥积瘀结证可有效改善患者临床症状,降低尿蛋白,保护肾功能,提高患者生活质量,与对照药物厄贝沙坦比较,疗效更佳。
文摘目的:探索清热消癥方在减少糖尿病肾脏疾病(DKD)患者蛋白尿方面的有效性和安全性,并对其疗效机制进行初步探索。方法:将符合本研究要求的60例DKD患者按1∶1随机分为对照组和试验组,每组30例,分别接受西医常规治疗、西医常规配合清热消癥方治疗,疗程共24周,以24 h尿蛋白(24 h UTP)为主要疗效指标,以肾功能[肾小球滤过率(eGFR)、血肌酐(Scr)、血尿素氮(BUN)]、内热积分及生活质量评分[躯体健康总分(PCS)和心理健康总分(MCS)]为次要疗效指标,检测患者治疗前后血清肿瘤坏死因子-α(TNF-α)和可溶性肿瘤坏死因子1、2型受体(sTNFR1、sTNFR2)水平,并进行安全性评价。结果:试验组患者24 h UTP的下降程度显著高于对照组(P<0.01)。试验组患者治疗前后的肾功能差异无统计学意义,而对照组患者Scr较治疗前显著升高(P<0.05)。试验组患者内热积分较治疗前显著降低、生活质量评分显著提高(P<0.05,P<0.01)。试验组患者治疗前后血清各炎症因子水平差异无统计学意义,而对照组患者血清sTNFR1水平较治疗前显著升高(P<0.05),且其增加程度显著高于试验组(P<0.05)。患者在试验期间未发生与药物直接相关的不良反应。结论:在西医常规治疗的基础上配合清热消癥方可以更为有效地改善DKD患者的蛋白尿,延缓肾功能进展,改善临床症状,提高生活质量,减轻炎症状态可能是其作用机制之一,然而其远期疗效仍需要进一步研究。
