| 引用本文: |
彭亚军,胡淑娟,张伟宁,刘秀,王诚喜,喻嵘.2型糖尿病肾病Ⅲ期患者气阴两虚、瘀毒互结证与内皮细胞功能障碍相关性分析[J].湖南中医药大学学报,2022,42(1):129-133[点击复制] |
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| 2型糖尿病肾病Ⅲ期患者气阴两虚、瘀毒互结证与内皮细胞功能障碍相关性分析 |
| 彭亚军,胡淑娟,张伟宁,刘秀,王诚喜,喻嵘 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学, 湖南 长沙 410208;衡阳市中医院, 湖南 衡阳 421001) |
| 摘要: |
| 目的 分析2型糖尿病肾病Ⅲ期患者气阴两虚、瘀毒互结证与内皮细胞功能障碍的相关性，为糖尿病肾病早期肾脏损伤的中医辨证提供一定的客观化依据。方法 选取2020年10月至2021年4月湖南中医药大学第一附属医院内分泌、肾病门诊及住院就诊的病人，符合纳入标准的2型糖尿病肾病Ⅲ期气阴两虚、瘀毒互结证患者20例，2型糖尿病患者20例，检测两组患者内皮细胞功能障碍相关性指标，并分析两组各项指标的差异。结果 两组患者内皮细胞功能障碍相关指标比较，2型糖尿病肾病Ⅲ期气阴两虚、瘀毒互结证组血管内皮生长因子（vascular endothelial growth factor，VEGF）、内皮素-1（endothelin-1，ET-1）均较2型糖尿病组升高，差异有统计学意义（P<0.05），内皮型一氧化氮合酶（endothelial nitric oxide synthase，eNOS）及一氧化氮（nitric oxide，NO）较2型糖尿病组稍有下降，但差异无统计学意义（P>0.05），血管内皮细胞钙粘连蛋白（VE-cadherin）、神经型钙粘连蛋白（N-cadherin）较2型糖尿病组表达下降，差异有统计学意义（P<0.05）。内皮细胞功能障碍相关指标与尿微量白蛋白/肌酐比值（urine albumin-to-creatinine ratio，UACR）相关性分析结果显示，UACR与VEGF（r=0.921）、UACR与ET-1（r=0.852）、UACR与VE-cadherin（r=0.918）、UACR与N-cadherin（r=0.884）具有相关性（P<0.05）。而UACR与eNOS（r=0.271）、UACR与NO（r=0.731）无明显相关性。结论 内皮细胞功能障碍且血清学指标变化可能是早期肾损害的敏感指标；内皮细胞功能障碍与中医气阴两虚、瘀毒互结证之间可能存在一定的相关性，可以作为客观辨识2型糖尿病肾病Ⅲ期气阴两虚、瘀毒互结证的部分生物学基础及依据。 |
| 关键词: 2型糖尿病肾病Ⅲ期 气阴两虚 瘀毒互结 内皮细胞功能障碍 |
| DOI：10.3969/j.issn.1674-070X.2022.01.025 |
| 投稿时间：2021-09-05 |
| 基金项目:国家重点研发计划中医药现代化研究重点专项（2018YFC1704400）；中国博士后面上资助项目（2020M682579）；湖南省中医药科研计划重点项目（2021027）；湖南省卫生健康委科研计划项目（202103052112）。 |
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| Analysis of the correlation of the syndrome of deficiency of both Qi and Yin and intertwined blood stasis and toxin with endothelium dysfunction in patients with type 2 diabetic nephropathy-stage Ⅲ |
| PENG Yajun,HU Shujuan,ZHANG Weining,LIU Xiu,WANG Chengxi,YU Rong |
| (The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Hengyang Hospital of Traditional Chinese Medicine, Hengyang, Hunan 421001, China) |
| Abstract: |
| Objective To analyze the correlation of the syndrome of deficiency of both Qi and Yin and intertwined blood stasis and toxin in type 2 diabetic nephropathy (DN)-stage Ⅲ with endothelium dysfunction and thereby provide a certain objective basis for the traditional Chinese medicine (TCM) syndrome differentiation of early kidney damage in DN. Methods Patients with endocrinology and nephropathy outpatients and inpatients in The First Affiliated Hospital of Hunan University of Chinese Medicine from October 2020 to April 2021 were selected, including 20 patients with The syndrome of deficiency of both Qi and Yin and intertwined blood stasis and toxin with type 2 DN-stage Ⅲ, and 20 patients with type 2 diabetes. Endothelium dysfunction-related indicators of two groups of patients were measured, and the difference between two groups were analyzed. Results According to comparison of related indicators of endothelial cell dysfunction between the two groups, the syndrome of deficiency of both Qi and Yin and the intertwined blood stasis and toxin with type 2 DN-stage Ⅲ group showed higher vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) than the type 2 diabetes group, the difference was statistically significant (P<0.05), the endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) were slightly lower than the type 2 diabetes group, but the difference was not statistically significant (P>0.05), the VE-cadherin and N-cadherin expression was lower than the type 2 diabetes group, the difference was statistically significant (P<0.05). The results of correlation analysis between indicators related to endothelial dysfunction and urine albumin-to-creatinine ratio (UACR) showed that, UACR was correlated with VEGF (r=0.921), UACR was correlated with ET-1 (r=0.852), UACR was correlated with VE-cadherin (r=0.918), UACR was correlated with N-cadherin (r=0.884) (P<0.05). There was no significant correlation between UACR and eNOS (r=0.271), UACR and NO (r=0.731). Conclusion Endothelium dysfunction and changes in serological indicator may be sensitivity indicators of early kidney damage. Endothelium dysfunction shows certain correlation to the syndrome of deficiency of both Qi and Yin and the intertwined blood stasis and toxin according to TCM. Therefore, it may serve as a partial biological basis for the objective identification of the syndrome of deficiency of both Qi and Yin and the intertwined blood stasis and toxin in type 2 DN-stage Ⅲ. |
| Key words: type 2 diabetic nephropathy-stage Ⅲ deficiency of both Qi and Yin intertwined blood stasis and toxin endothelium dysfunction |
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