中西医结合治疗早期糖尿病肾脏疾病30例临床观察

Clinical observation of 30 cases of patients with early diabetic kidney disease treated by combined therapy of chinese and western medicine

目的观察中西医结合治疗早期糖尿病肾脏疾病(DKD)的临床疗效方法将60例DKD患者随机分为2组。对照组30例采用西医常规对症治疗,治疗组30例在对照组治疗基础上加用益气活血汤治疗。2组均1个月为1个疗程,3个疗程后比较2组临床疗效及治疗前后中医证候积分、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_1c)、尿白蛋白排出率(UAER)、内生肌酐清除率(Ccr)及血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)]变化。结果治疗组总有效率90.0%,对照组总有效率63.3%,治疗组疗效优于对照组(P<0.05);2组治疗后中医证候积分均降低(P<0.05),且治疗组低于对照组(P<0.05);2组治疗后FPG、HhA_1c、UAER均降低(P<0.05),Ccr升高(P<0.05),且2组组间比较差异有统计学意义(P<0.05);2组治疗后TC、TG、HDL-C及LDL-C均改善(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论中西医结合治疗糖尿病肾病临床疗效确切。

Objective To observe the effect of patients with early diabetic kidney disease （DKD） treated by combined therapy of Chinese and Western medicine. Methods 60 cases of DKD were randomly divided into two groups. 30 cases in control group were given western medicine symptomatic treatment. 30 cases in treatment group were treated by qi and activating blood decoction. The therapeutic period is three months. The clinical curative effect and TCM syndrome score before and after treatment, the changes of fasting plasma glucose （FPG） , 2 - hour postpran- dial plasma glucose （ 2 hPG）, glycosylated hemoglobin A1 c （ HhA1 c）, urinary albumin excretion rate （ UAER）, creat- inine clearance rate（Ccr） and blood lipid indexs were compared between two groups. Results The total effective rate was 90.0% in treatment group and 63.3% in control group; there was significant difference between two group （ P 〈 0.05 ）. After treatment, TCM syndrome score and FPG, HbA1 c 、 UAER were decreased in two groups （ P 〈 0.05） ,and the decrease in treatment group was obvious（P 〈0.05）. Ccr after treatment was increased in two groups （ P 〈 0.05 ） , and the increase in treatment group was obvious （ P 〈 0.05 ）. The triglycerides （ TG）, total cholesterol （TC） , high density lipoprotein cholesterol （ HDL - C） and low density lipoprotein cholesterol （ LDL - C） after treat- ment was significantly improved in two groups （ P 〈 0.05 ）, but there was no significant difference between two gorups （ P 〈 0.05 ）. Conclusion Combined therapy of Chinese and Western medicine has an exact effect on DKD.