健脾固肾化瘀方治疗脾肾两虚夹瘀型糖尿病肾脏病的疗效及对相关生物标志物的影响OACSTPCD

[Objective]To investigate the clinical efficacy of Jianpi Gushen Huayu Decoction combined with losartan potassium tablets in the treatment of spleen and kidney deficiency and blood stasis syndrome diabetic kidney disease and its effect on serum matrix metalloproteinase-9(MMP-9),monocyte chemoattractant protein-1(MCP-1)and vascular endothelial growth factor(VEGF)levels.[Methods]From January 2019 to May 2021,80 patients with DKD of spleen and kidney deficiency and blood stasis type admitted to our hospital were selected as the research objects.They were divided into observation group and control group by random number table method,with 40 cases in each group.The observation group was treated with Jianpi Gushen Huayu Decoction combined with losartan potassium tablets,and the control group was treated with losartan potassium tablets alone.The clinical efficacy of the two groups was observed after 12 weeks of continuous treatment.Blood glucose[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG)and glycosylated hemoglobin(HbA1c)],blood lipids[total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)]and renal function indexes[urinary albumin excretion rate(UACR),creatinine(SCr)and urea nitrogen(BUN)]were detected before and after treatment.Serum MMP-9,MCP-1 and VEGF levels were measured by enzyme-linked immunosorbent assay.The side effects of the two groups were counted.[Results]The total effective rate of the observation group was 92.50%(37/40),which was significantly higher than that of the control group[72.50%(29/40)](P＜0.05).After treatment,FPG,2h PG and HbA1c in the two groups were significantly lower than those before treatment(P＜0.05),and the improvement in the observation group was more significant(P＜0.01).After treatment,the serum TC,TG and LDL-C concentrations in the two groups were significantly lower than those before treatment(P＜0.05),and the improvement in the observation group was more significant(P＜0.01).After treatment,UAER and serum SCr and BUN levels in the two groups were significantly lower than those before treatment(P＜0.05),and the improvement in the observation group was more significant(P＜0.01).After treatment,serum MMP-9 levels in both groups were significantly higher than those before treatment(P＜0.05),and serum MCP-1 and VEGF concentrations were significantly lower than those before treatment(P＜0.05).After treatment,the increase of serum MMP-9 level and the decrease of serum MCP-1 and VEGF levels in the observation group were more significant than those in the control group(P＜0.01).No obvious side effects occurred in all subjects.[Conclusion]The application of Jianpi Gushen Huayu Decoction combined with losartan potassium tablets in the treatment of spleen and kidney deficiency and blood stasis syndrome diabetic kidney disease can safely and effectively up-regulate the expression level of MMP-9 in the blood of patients,down-regulate the expression levels of MCP-1 and VEGF in the blood,and improve renal function.The overall effect is definite.