糖肾复元汤结合西医常规疗法治疗老年糖尿病肾病临床观察

Clinical observation of "Tangshen Fuyuan Decoction" combined with western medicine in treating elderly diabetic nephropathy

目的探讨糖肾复元汤结合西医常规疗法治疗气阴两虚兼脉络瘀阻型老年糖尿病肾病的临床疗效。方法将50例年龄大于60岁的糖尿病肾病患者随机分为治疗组30例和对照组20例。两组均采用西医常规疗法,治疗组同时加服糖肾复元汤,对照组加服六味地黄丸。两组疗程均为8周,观察临床疗效及治疗后空腹血糖(FPG)、餐后2小时血糖(2hPG)、血尿素氮(BUN)、肌酐(Scr)、尿微量白蛋白(mALB)、血β2-微球蛋白(β2-MG)的变化情况。结果治疗组、对照组总有效率分别为93.3%、60.0%,组间疗效差异有统计学意义(P<0.05);治疗组在改善气短神疲、口干多饮、腰膝酸软、下肢浮肿、尿量多、尿混浊有泡沫等症状方面也明显优于对照组(P<0.05,P<0.01)。治疗组FPG、2hPG、BUN、Scr、mALB、β2-MG治疗前后比较,差异有统计学意义(P<0.01);对照组FPG、2hPG、BUN、Scr、mALB治疗前后比较,差异有统计学意义(P<0.01);组间治疗后比较,BUN、Scr、mALB、β2-MG差异有统计学意义(P<0.05,P<0.01)。结论糖肾复元汤结合西医常规疗法治疗气阴两虚兼脉络瘀阻型老年糖尿病肾病疗效显著。

Objective To investigate the clinical effect of ＂Tangshen Fuyuan Decoction＂ combined with western medicine in the treatment of elderly diabetic nephropathy（DN） of qi-yin deficiency and blood-stasis.Methods Fifty DN cases were randomized into two groups： treatment group in which 30 cases were treated by routine modality and ＂Tangshen Fuyuan Decoction＂ and control group in which 20 cases were treated by routine modality and ＂Liuwei Dihuang Pill＂,with a course of 8 weeks.The contents of FPG,2hPG,BUN,Scr,mALB and β2-MG were detected before and after the treatment.Results The total effective rate was 93.3% in the treatment group and 60.0% in the control group,with a difference between the two rates（P〈0.05）;the treatment group had better effects than the control group in improving such symptoms as fatigue and edema（P〈0.05,P〈0.01）.There were striking differences in the contents of FPG,2hPG,BUN,Scr,mALB and β2-MG between before and after treatment in the treatment group（P〈0.01）,and in FPG,2hPG,BUN,Scr and mALB in the control group（P〈0.01）.After treatment,there were differences in the contents of BUN,Scr,mALB and β2-MG between the two groups（P〈0.05,P〈0.01）.Conclusion ＂Tangshen Fuyuan Decoction＂ combined with western medicine is quite effective for elderly diabetic nephropathy（DN） of qi-yin deficiency and blood-stasis.