益气养阴清热活血法治疗早期糖尿病肾病33例临床观察

Observation of prescription with supplementing qi,nourishing yin,clearing heat and activating blood on early diabetic nephropathy

目的观察益气养阴清热活血法治疗早期糖尿病肾病的临床疗效。方法将65例早期糖尿病肾病患者随机分为2组,对照组32例采用常规西药治疗,治疗组33例在对照组治疗基础上加用益气养阴清热活血中药治疗。2组疗程均8周。观察2组治疗前后临床疗效,空腹血糖(FPG)、餐后2小时血糖(2 hPG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、24 h尿微量白蛋白排泄率(UAER)、血清总胆固醇(TC)、血清甘油三脂(TG)的变化和临床症状积分的变化。结果2组总有效率比较差异有统计学意义(P<0.05),治疗组较对照组更能明显改善早期糖尿病肾病患者的临床症状。2组治疗后FPG、HbA1c、CRP、UAER与本组治疗前比较差异均有统计学意义(P<0.05,P<0.01),治疗后优于治疗前;2组治疗后UAER、CRP比较差异有统计学意义(P<0.05),治疗组在减少UAER,降低CRP水平方面优于对照组。2组治疗后临床症状积分均明显降低,与本组治疗前比较差异有统计学意义(P<0.05,P<0.01),2组均可改善糖尿病肾病临床症状;2组治疗后临床症状积分比较差异有统计学意义(P<0.05),治疗组在改善早期糖尿病肾病患者临床症状方面优于对照组。结论益气养阴清热活血法治疗早期糖尿病肾病有较好疗效。

Objective To evaluate the effect of prescription with supplementing qi, nourishing yin, clearing heat and activating blood on diabetic nephropathy. Methods 65 patients with early diabetic nephropathy were randomly divided into two groups. 32 cases in control group were treated by routine therapy. Patients in treatment group （ n = 33） were treated by combination of prescription with supplementing qi, nourishing yin, clearing heat and acti- vating blood and routine therapy. The course in two groups was eight weeks. The changes of clinical effect, FPG, postprandial glucose, HbAlc, CRP, UAER, TC, TG and integral of clinical symptoms were observed before and after treatment. Results Improvements of UAER and CRP in treatment group were superior to those in control group. Integrals of clinical syndrome were obviously decreased after treatment in two groups. There were obvious differences between two groups on total effective rate, UAER, CRP and integrals of clinical syndrome after treatment （ P 〈 0.05）. There were significant differences between before and after treatment in two groups on FPG, HbAlc, CRP and UAER （ P 〈 0.05, P 〈 0.01 ）. Conclusion The prescription with supplementing qi, nourishing yin, clearing heat and activating blood has a good effect on diabetic nephropathy.