参芪地黄汤治疗早期糖尿病肾病临床研究

Clinical Research on Shenqi Dihuang Tang in Treating Early Diabetic Nephropathy

目的:观察参芪地黄汤治疗早期糖尿病肾病的临床疗效,及其对血脂和炎症反应指标的影响。方法:105例患者随机分为研究组53例和对照组52例。对照组给予盐酸贝那普利片或氯沙坦钾片口服以控制血压;研究组在对照组基础上给予参芪地黄汤。两组疗程均为12周。检测治疗前后24小时尿蛋白定量,尿微量白蛋白/肌酐、胆固醇、三酰甘油、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)水平、空腹血糖(fasting blood-glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,Hb Alc)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白介素6(interleukin-6,IL-6)及C反应蛋白(C-reactive protein,CRP)水平。结果:治疗后研究组有效率为88.68%,对照组为70.08%,研究组优于对照组(χ2=4.143,P<0.05);治疗后研究组24小时尿蛋白定量、尿微量白蛋白/肌酐和Hb Alc水平低于对照组(P<0.05,P<0.01);治疗后研究组胆固醇、三酰甘油水平低于对照组(P<0.05),两组LDL-C和HDL-C水平组间比较,差异无统计学意义(P>0.05);研究组治疗后CRP、TNF-α、IL-6水平低于对照组(P<0.01)。结论:参芪地黄汤治疗早期糖尿病肾病,能调节糖脂代谢,减轻炎症反应,从而减少24小时尿蛋白、尿微量白蛋白/肌酐,对早期糖尿病肾病进展起到了延缓作用。

Objective：To observe the clinical effect of Shenqi Dihuang Tang in treating early diabetic nephropathy and its effect on the serum lipids and inflammatory response. Methods：95 patients were randomly divided into the study group of 53 cases and the control group of 52 cases. The control group was given benazepril hydrochloride tablets or losartan potassium tablets to control blood pressure. In study group was treated with Shenqi Dihuang Tang on the basis of the control group. The courses of two groups was 12 weeks. Detec- ted 24 hour urinary protein, urinary albumin / creatinine, cholesterol, triglyeeride, high density lipoprotein cholesterol （ HDL-C ） , low density lipoprotein cholesterol, （ LDL-C ） level, fasting blood-glucose （ FPG）, glyeosylated hemoglobin （ HbAlc）, tumor necrosis factor-al- pha （ TNF-α）, interleukin-6 （ IL-6 ） and C-reactive protein （CRP） level before and after treatment. Results ： After treatment, the effective rate of study group was 88.68% ,and the control group 70.08% ,and the study group was better than control group（χ2 =4. 143 ,P 〈 0. 05 ）. After treatment ,24 hours urinary protein, urinary albumin / creatinine and HbAlc levels of the study group were lower than the control group（ P 〈 0.05 ,P 〈 0.01 ）. After treatment, cholesterol and triglyceride levels of the study group were lower than the control group （ P 〈 0.05 ）, compaison of LDL-C and HDL-C level of two groups had no statistical significance （ P 〉 0.05 ） ; after treatment, CRP and TNF-α, IL-6 levels of study group were lower than control group （ P 〈 0.01 ）. Conclusion ： Shenqi Dihuang Tang addition and sub- traction for the treatment of early diabetic nephropathy can regulate glucose and lipid metabolism, reduce inflammation, reduce 24 hour urinary protein, urinary albumin / creatinine, which play delayed action for the progression of early diabetic nephropathy.