加味黄风汤辅助治疗风湿内扰型糖尿病肾病临床观察

Clinical observation of Jiawei Huangfeng Decoction in treating diabetic nephropathy with rheumatic disturbance

目的早期肾脏病变具有隐匿性,糖尿病肾病(diabetic nephropathy,DN)发现时一般已进展成Ⅲ期,且很难逆转其病情发展。本研究探讨加味黄风汤辅助治疗风湿内扰型DN患者效果。方法选取鹤壁中医骨科医院中医科2017-12-01-2019-05-31收治的风湿内扰型DN患者76例,按照性别、年龄、病程等因素组间匹配的原则分为对照组和治疗组,各38例。对照组给予降糖和降压等基础治疗;治疗组在对照组基础上加用加味黄风汤辅助治疗。8周后比较两组临床疗效、24h尿蛋白定量、血清肌酐(serum creatinine,Scr)、尿素氮(blood urea nitrogen,BUN)、肾小球滤过率(glomerular filtration rate,GFR)、C-反应蛋白(C-reactive protein,CRP)及不良反应发生率。结果治疗组总有效率为89.47%,高于对照组的68.42%,χ2=5.067,P=0.024。治疗后,治疗组24h尿蛋白定量为(0.72±0.29)g,低于对照组的(0.98±0.31)g,t=3.776,P<0.05;SCr为(80.05±6.14)μmol/L,低于对照组的(85.77±8.930)μmol/L,t=3.254,P<0.05;BUN为(6.12±1.93)mmol/L,低于对照组的(6.47±1.52)mmol/L,t=3.559,P<0.05;CRP为(7.98±2.58)mg/L,低于对照组的(9.82±1.76)mg/L,t=8.880,P<0.05。结论加味黄风汤辅助治疗风湿内扰型DN效果明显,不仅可以改善肾功能,降低尿蛋白、SCr、CRP等,且安全可靠。

OBJECTIVE Early nephropathy is occult,diabetic nephropathy(DN)has generally progressed to stageⅢwhen it is discovered,and it is difficult to reverse its development.This study explores the effect of Jiawei Huangfeng Decoction in the treatment of patients with rheumatic internal disturbance type DN.METHODS A total of 66 patients with rheumatic internal disturbance type DN who were admitted to Hebi Traditional Chinese Medicine Orthopedics Hospital from December 01,2017 to May 31,2019 were selected and divided into control and treatment group according to the principle of matching between groups based on gender,age,course of disease,etc,38 cases in each group.The control group was given basic therapy such as hypoglycemic and antihypertensive,the treatment group was supplemented with Jiawei Huangfeng Decoction on the basis of the control group.After 8 weeks,the clinical efficacy,24-hour urine protein quantitation,and serum creatinine(Scr),blood urea nitrogen(BUN),glomerular filtration rate(GFR),C-reactive protein(CRP)and incidence of adverse reactions were compared between the two groups.RESULTS The total effective rate in the treatment group was 89.47%,which was higher than that of the control group(68.42%),χ~2=5.067,P=0.024.After treatment,the quantitative urine protein in the treatment group at 24 hwas(0.72±0.29)g,which was lower than that of the control group(0.98±0.31)g,t=3.776,P<0.05.SCr was(80.05±6.14)μmol/L,which was lower than that of the control group(85.77±8.930)μmol/L,t=3.254,P<0.05.BUN was(6.12±1.93)mmol/L,which was lower than that of the control group(6.47±1.52)mmol/L,t=3.559,P<0.05.CRP was(7.98±2.58)mg/L,which was lower than that of the control group(9.82±1.76)mg/L,t=8.880,P<0.05.CONCLUSIONS The supplementary treatment of rheumatic internal disturbance type DN with Jiawei Huangfeng Decoction had obvious effect.It could not only improve renal function,reduce urine protein,SCr,CRP,etc,but also safe and reliable.