益气活血汤对糖尿病肾病患者血清CRP，IL-8的影响

Effect of Yiqi Huoxue Decoction on Serum CRP and IL-8 in Patients with Diabetic Nephropathy

摘要:

目的：观察益气活血汤治疗气阴两虚兼血瘀型糖尿病肾病患者的临床疗效，从微炎症角度探讨其作用机制。方法：筛选气阴两虚兼血瘀型糖尿病肾病患者70例，采用随机、平行对照的研究方法，根据患者就诊的先后顺序编号，对应随机数字表随机分为对照组（34例）、治疗组（36例）。两组患者均给予基础方案（饮食控制、降糖、降压、降脂等）配合中药汤剂治疗，对照组予以糖尿病（diabetes mellitus，DM）120方，治疗组予以益气活血汤，疗程为12周。治疗前及治疗后分别检测并比较两组患者的血肌酐、尿素氮、血清白蛋白、肾小球滤过率、尿微量白蛋白/肌酐、血清C反应蛋白（CRP）及白细胞介素-8（IL-8）水平。结果：与治疗前比较，治疗第12周，治疗组患者的血肌酐降低（P<0.05），血清白蛋白升高（P<0.01），肾小球滤过率升高（P<0.01），尿微量白蛋白/肌酐降低（P<0.01），血清CRP和IL-8水平亦降低（P<0.05）；同时，治疗组在降低尿微量白蛋白/肌酐，升高血清白蛋白，下调血CRP，IL-8水平方面均优于对照组（P<0.05）。结论：益气活血汤能改善早期糖尿病肾病（DKD）患者的肾功能，降低尿蛋白，具有早期干预糖尿病肾病进展的作用，其机制可能与抑制血CRP，IL-8等炎症因子水平，从而改善DKD机体的微炎症状态有关。

Abstract:

Objective: To observe the clinical efficacy of Yiqi Huoxue decoction on patients with diabetic kidney disease with Qi and Yin deficiency and blood stasis syndrome, in order to explore its mechanism from the perspective of micro-inflammatory. Method: A randomized, parallel-controlled clinical trial was conducted. A total of 70 patients of diabetic nephropathy with Qi and Yin deficiency and blood stasis syndrome were randomly divided into control group (34 cases) and treatment group (36 cases) according to the random number table. The two groups of patients were given basic treatment (including control diet, blood glucose, blood pressure, lipids) and traditional Chinese medicine. The treatment group was given Yiqi Huoxue decoction for 12 weeks, while the control group was given DM120 formula. Before and after treatment, the patients' serum creatinine, urea nitrogen, serum albumin, urinary albumin/creatinine ratio, serum C-reactive protein (CRP) and interleukin-8 (IL-8) were detected. Result: In treatment group, patients' serum creatinine, urinary albumin/creatinine ratio, serum CRP and IL-8 decreased (P<0.05, P<0.01); serum albumin and glomerular filtration rate obviously increased (P<0.01) after 12 weeks. At the same time, treatment group was superior to control group in decrease of the urinary albumin /creatinine ratio, increase of serum albumin and inhibition of serum CRP and IL-8 (P<0.05). Conclusion: Yiqi Huoxue decoction can protect the renal function of diabetic kidney disease(DKD) patients, decrease proteinuria, and delay the progress of DKD in the early stage. And its mechanism may be related to inhibition of the levels of inflammatory cytokines, such as CRP and IL-8, which can improve the micro inflammatory state of DKD.