中药内服外治改善糖尿病肾病Ⅳ期肾功能的临床观察

Clinical Observation of the Curative Effect on Diabetic Nephropathy of Ⅳ Phase Treated with Traditional Chinese Medicine

目的观察肾衰合剂加灌肠Ⅰ号治疗糖尿病肾病Ⅳ期的临床疗效。方法糖尿病肾病(DN)Ⅳ期58例,按肾功能分为2组:A组,20 ml/min<Ccr<50 ml/min;B组10 ml/min<Ccr<20 ml/min。每组又分为中药组和对照组。中药组加用肾衰合剂及灌肠Ⅰ号,对照组加用爱西特。结果A、B组血肌酐Scr治疗后均低于治疗前,内生肌酐清除率Ccr治疗后均高于治疗前,且治疗后A组中的中药组优于对照组;甘油三酯(TG)、尿NAG、24h尿蛋白定量,A、B两组治疗后中药组低于对照组,有显著性差异(P<0.05)。结论肾衰合剂加灌肠Ⅰ号能改善糖尿病肾病Ⅳ期的肾功能,尤其在肾功能失代偿期疗效优于爱西特。

Objective To investigate the clinical effect of combination of Shenshuaiheji misture and Guanchang Ⅰ enema on diabetic nephropathy （DN） of Ⅳ phase. Methods 58 cases of DN were divided into two groups, group A （20ml/min〈Ccr〈50 ml/min） and group B （10 ml/min〈Ccr〈20 ml/min）. Each group was divided into the traditional Chinese medicine （TCM） group and the control group again. The TCM group was treated with Shenshuaiheji misture and Guanchang Ⅰ. The control group was treated with activated charcoal. Serum creatinine （Scr）, blood urea nitrogen （BUN）, blood-fat, urine-NAG and 24h-UPr were tested before and after treatment. Results Scr level in both group A and group B was statistically lower after treatment than that of before treatment. Morever, the decrease was particularly significant in the TCM group in comparison with the control group. In both group A and B, TG, urine-NAG, 24h-UPr in TCM group were all statistically lower than that in control group （P〈0.05）. Conclusion Combination of Shenshuaiheji misture and Guanchang Ⅰ enema could decrease the urine protein and rectify the disorder of lipidemia metabolism so as to improve the blood circulation of renal and protect the renal function.