中药药理与临床2025，Vol.41Issue(3)：76-81,6.
通络地龟汤治疗糖尿病肾病患者的临床观察
Clinical Observation of Tongluo Digui(通络地龟)Decoction in the Treatment of Patients with Diabetic Nephropathy
摘要
Abstract
Objective:To observe the clinical efficacy of Tongluo Digui(通络地龟)Decoction in the treatment of patients with diabetic nephropa-thy(DN)and the influences of this decoction on blood glucose,renal function,renal tubular injury,circadian rhythm changes of blood pres-sure,and expression profile of circulating long non-coding RNA(lncRNA)and messenger RNA(mRNA).Methods:A total of 83 patients with DN admitted to the hospital from June 2020 to January 2022 were selected and assigned into a control group(n=42)and an observation group(n=41)by the random number table method.The two groups were compared in terms of clinical efficacy as well as blood glucose inde-xes[fasting blood glucose(FBG)and glycosylated hemoglobin(HbAlc)],renal function indexes[serum creatinine(Scr)and cystatin C(CysC)],renal tubular injury indexes[urine β2-microglobulin(β2-MG),retinol-binding protein 4(RBP4),and neutrophil gelatinase-asso-ciated lipocalin(NGAL)],circadian rhythm changes of blood pressure,expression profiles of circulating lncRNA and mRNA,and TCM symp-tom scores before and after treatment.In addition,the adverse reactions were also compared between the two groups.Results:The total re-sponse rate in the observation group(85.37%)was higher than that in the control group(71.43%)(P>0.05).After treatment,both groups showed declines in the levels of FBG,HbAlc,Scr,CysC,urine β2-MG,RBP4,and NGAL,the 24 h systolic blood pressure variation co-efficient,24 h diastolic blood pressure variation coefficient,percentage of nocturnal diastolic blood pressure decrease,and percentage of noctur-nal systolic blood pressure decrease(P<0.05).Moreover,the observation group had lower indexes than the control group(P<0.05).After treatment,82 lncRNAs showed differential expression in the two groups,and 132 lncRNAs were up-regulated more than twice.The target genes were mainly related to actin cytoskeleton,focal adhesion,and Rap1 signaling pathway.After treatment,the TCM scores of Koukexiyin(口渴喜饮),Xinfanshimian(心烦失眠),Touyunermin(头晕耳鸣),Zhitimamu(肢体麻木),and Xiongbixintong(胸痹心痛)decreased in both groups(P<0.05),while the observation group had lower scores than the control group(P<0.05).There was no significant differ-ence in the total incidence of toxic side effects between the two groups(P>0.05).Conclusion:Tongluo Digui Decoction is effective in trea-ting DN patients.It shows obvious advantages in improving the circadian rhythm of blood pressure and ameliorating TCM symptoms,which may be related to regulating the expression of various lncRNAs,mRNAs,and downstream signaling pathways.关键词
糖尿病肾病/通络地龟汤/血压昼夜节律/循环lncRNA/mRNAKey words
Diabetic nephropathy/Tongluo Digui(通络地龟)Decoction/Circadian rhythm of blood pressure/Circulating lncRNA/mRNA引用本文复制引用
尹建平,李东洋,王学敏,庞欣欣..通络地龟汤治疗糖尿病肾病患者的临床观察[J].中药药理与临床,2025,41(3):76-81,6.基金项目
河南省卫生健康委项目-河南省中医药科学研究专项基金项目(编号:2019JDZX2119). （编号:2019JDZX2119）
