中医辨证治疗对糖尿病肾病肾功能不全患者蛋白非酶糖基化和蛋白激酶C激活的影响(1)
摘要 目的：探討中医辨证治疗糖尿病肾病肾功能不全患者对其蛋白非酶糖基化和蛋白激酶C激活的影，为糖尿病肾病肾功能不全患者的临床治疗提供参考。方法：选取2016年3月至2018年3月濮阳市中医医院收治的糖尿病肾病肾功能不全患者96例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组48例，其中对照组患者给予西医常规治疗，观察组患者在上述治疗的基础上外加中医辨证治疗，比较2组肾功能、蛋白激酶C(PKC)活性以及血糖、糖化血红蛋白水平变化，并分析2组治疗后肾脏血流相关参数的变化，观察2组临床疗效。结果：2组治疗前肾功能相关指标、PKC活性以及血糖、糖化血红蛋白水平差异无统计学意义(P>0.05)，具有可比性。治疗后观察组患者肌酐(Scr)和尿素氮(BUN)、胞质PKC活性、胞膜PKC活性以及空腹血糖、糖化血红蛋白水平均明显下降，SCr水平升高，差异有统计学意义(P<0.05)。与对照组比较，观察组肾主动脉(MRA)、段动脉(SRA的Vsmax差异无统计学意义(P>0.05)，Vdmin明显升高，RI明显降低(P<0.05);IRA的Vdmin、Vsmax明显升高，RI明显降低(P<0.05)。观察组患者的治疗有效率为95.83%，明显高于对照组的70.83%，差异有统计学意义(P<0.05)。结论：中医辨证治疗糖尿病肾病肾功能不全患者可以有效的抑制PKC通路的激活，减轻蛋白非酶糖基化的发生，纠正肾血流动力学异常，改善肾功能，效果显著。
关键词 中医辨证疗法;糖尿病肾病肾功能不全;蛋白非酶糖基化;蛋白激酶C;肾动脉、肾叶段动脉;肾叶间动脉;阻力指数;舒张期最低血流速度;收缩期最大血流速度
Effects of TCM Syndrome Differentiation on Non Enzymatic Glycosylation of Protein and Activation of Protein Kinase C and the Relationship with Hemodynamic Abnormalities in Diabetic Nephropathy Patients with Renal Insufficiency
Wu Yonghua1，Huang Junchen1，Hu Yanhui2
(1 Endocrinology and Geriatrics Department，Puyang Traditional Chinese Medicine Hospital，Puyang 457000，China; 2 Department of Integrated Traditional Chinese and Western Medicine，Cancer Hospital Affiliated to Zhengzhou University，Zhengzhou 450000，China)
Abstract Objective：To investigate the effects of dialectical treatment of diabetic nephropathy renal insufficiency on protein non-enzymatic glycosylation and protein kinase C activation and its relationship with hemodynamic abnormalities，and provide reference for clinical treatment of patients with diabetic nephropathy renal insufficiency.Methods：A total of 96 patients with renal insufficiency due to diabetic nephropathy were admitted to Puyang Traditional Chinese Medicine Hospital from March 2016 to March 2018 and they were randomly divided into observation group and control group，with 48 cases in each group.The control group was given routine Western medicine treatment，and the patients in the observation group were treated with the dialectical treatment of traditional Chinese medicine (TCM) based on the above-mentioned treatment.The renal function，protein kinase C (PKC) activity，and changes in blood glucose and glycosylated hemoglobin levels before and after treatment were compared between the two groups.The changes of blood flow related parameters after treatment in the two groups of patients were analyzed to observe the clinical efficacy of the two groups after treatment.Results：There was no significant difference between the two groups in terms of parameters related to renal function before treatment，PKC activity，and blood glucose and glycosylated hemoglobin levels (P>0.05).After treatment，the SCr，BUN，cytoplasmic PKC activity，membrane PKC activity，fasting blood glucose，and hemoglobin A1c of the patients in the observation group significantly decreased，and Ccr levels significantly increased，which was statistically significant (P<0.05).Compared with the control group，Vsmax of MRA and SRA in the observation group had no significant difference (P>0.05)，and Vdmin increased significantly，RI decreased significantly (P<0.05)，while Vdmin，Vsmax of IRA increased significantly and RI decreased significantly (P<0.05).The effective rate in the observation group was 95.83%，which was significantly higher than that in the control group (70.83%).The difference was statistically significant (P<0.05).Conclusion：The dialectical treatment of diabetic nephropathy patients with renal insufficiency can effectively inhibit the activation of PKC pathway，reduce protein non-enzymatic glycosylation，correct renal hemodynamic abnormalities，improve renal function，the effect is significant., 百拇医药(武永华 黄俊臣 胡彦辉)
关键词 中医辨证疗法;糖尿病肾病肾功能不全;蛋白非酶糖基化;蛋白激酶C;肾动脉、肾叶段动脉;肾叶间动脉;阻力指数;舒张期最低血流速度;收缩期最大血流速度
Effects of TCM Syndrome Differentiation on Non Enzymatic Glycosylation of Protein and Activation of Protein Kinase C and the Relationship with Hemodynamic Abnormalities in Diabetic Nephropathy Patients with Renal Insufficiency
Wu Yonghua1，Huang Junchen1，Hu Yanhui2
(1 Endocrinology and Geriatrics Department，Puyang Traditional Chinese Medicine Hospital，Puyang 457000，China; 2 Department of Integrated Traditional Chinese and Western Medicine，Cancer Hospital Affiliated to Zhengzhou University，Zhengzhou 450000，China)
Abstract Objective：To investigate the effects of dialectical treatment of diabetic nephropathy renal insufficiency on protein non-enzymatic glycosylation and protein kinase C activation and its relationship with hemodynamic abnormalities，and provide reference for clinical treatment of patients with diabetic nephropathy renal insufficiency.Methods：A total of 96 patients with renal insufficiency due to diabetic nephropathy were admitted to Puyang Traditional Chinese Medicine Hospital from March 2016 to March 2018 and they were randomly divided into observation group and control group，with 48 cases in each group.The control group was given routine Western medicine treatment，and the patients in the observation group were treated with the dialectical treatment of traditional Chinese medicine (TCM) based on the above-mentioned treatment.The renal function，protein kinase C (PKC) activity，and changes in blood glucose and glycosylated hemoglobin levels before and after treatment were compared between the two groups.The changes of blood flow related parameters after treatment in the two groups of patients were analyzed to observe the clinical efficacy of the two groups after treatment.Results：There was no significant difference between the two groups in terms of parameters related to renal function before treatment，PKC activity，and blood glucose and glycosylated hemoglobin levels (P>0.05).After treatment，the SCr，BUN，cytoplasmic PKC activity，membrane PKC activity，fasting blood glucose，and hemoglobin A1c of the patients in the observation group significantly decreased，and Ccr levels significantly increased，which was statistically significant (P<0.05).Compared with the control group，Vsmax of MRA and SRA in the observation group had no significant difference (P>0.05)，and Vdmin increased significantly，RI decreased significantly (P<0.05)，while Vdmin，Vsmax of IRA increased significantly and RI decreased significantly (P<0.05).The effective rate in the observation group was 95.83%，which was significantly higher than that in the control group (70.83%).The difference was statistically significant (P<0.05).Conclusion：The dialectical treatment of diabetic nephropathy patients with renal insufficiency can effectively inhibit the activation of PKC pathway，reduce protein non-enzymatic glycosylation，correct renal hemodynamic abnormalities，improve renal function，the effect is significant., 百拇医药(武永华 黄俊臣 胡彦辉)
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