补阳还五汤联合胰岛素用于2型糖尿病早期肾损伤的临床研究

Clinical study on the effects of Buyang-Huanwu decoction combined with western medicine on early renal injury of patients with type 2 diabetes

目的探讨补阳还五汤配合胰岛素用于2型糖尿病早期肾损伤的临床疗效。方法将2009年3月至2011年3月湖南省永州市中心医院就诊的200例早期糖尿病。肾损伤患者，按入院顺序随机分为两组各100例。对照组采用注射胰岛素控制血糖含量，并严密监视血压、血脂变化，口服盐酸贝那普利；研究组在对照组治疗基础上加用中药补阳还五汤，并随症加减。结果研究组总有效率为86％，对照组为67％，两组比较差异有统计学意义（X^2=15．62，P〈0．01）。两组患者治疗后空腹血糖（FBG）、餐后2小时血糖（2hPG）、舒张压（DBP）、收缩压（SBP）、糖化白蛋白（HbAlc）均较同组治疗前明显降低（研究疗组t值分别为4．23，4．47，3．59，3．87，3．99；对照组t值分别为4．34、4．76、4．05、3．78、3．69，P〈0．05），但组间治疗后比较，差异无统计学意义（P〉0．05）。对照组治疗后肾功能各指标检测结果与同组治疗前比较无明显变化（P〉0．05）；研究组治疗后尿微量蛋白（mALB）、尿素（Urea）、血清肌酐（Cr）较同组治疗前明显降低（t值分别为4．56、3．73、3．28，P〈0．05）；其中研究组治疗后mALB明显低于对照组（t=5．01，P〈0．05）。结论补阳还五汤配合西药治疗2型糖尿病早期肾损伤，可有效的减少尿蛋白、改善微循环、保护肾功能。

Objective To investigate the effects of Buyang-Huanwu decoction combined with western medicine on early diabetic renal injury. Methods 200 cases of early diabetic renal injury were randomly recruited into study group and control group, with 100 cases in each group. The control group was treated with insulin injection and oral benazepril hydrochloride, and the blood pressure, blood lipid changes were closely monitored; while the study group was additionally treated with Buyang-Huanwu decoction on the basis of the control group. Results The total therapeutic effects in the study group was significantly higher than the control group （X^2=15.62, P〈0.01）. The values of FBG, 2 h PG, DBP, SBP, HbAlc in both groups were significantly reduced after the treatment （P〈0.05, t=4.23, 4.47, 3.59, 3.87, 3.99 in the study group, t=4.34, 4.76, 4.05, 3.78, 3.69 in the control group） ; but the difference between the two groups had no significance （P〉0.05）. Before treatment mALB, Urea, Cr, TG and TC were not significantly different （P〉0.05） ; the values of mALB, Urea and Cr were significantly reduced in the study group after the treatment （P〈0.05, t=4.56, 3.73, 3.28）; especially mALB in the study group was obviously lower than the control group （P〈0.05, t=5.01）. Conclusion Buyang-Huanwu decoction combined with western medicine was effective to treat early renal damage of type 2 diabetes, with the functions of reducing urinary protein, improving microcirculation and protecting renal function.