滋水分清饮对血清胱抑素C在糖尿病肾病中医证型中的疗效观察

Effects of Zishui Fenqing decoction on serum cystatin C in patients with different TCM syndrome types of diabetic nephropathy

目的:观察滋水分清饮治疗糖尿病肾病各证型的疗效,并对其疗效机制进行初步探讨。方法:将符合入选标准的100例糖尿病肾病患者随机分为治疗组66例与对照组34例,对照组在控制饮食、运动治疗基础上给予常规西药降糖、降压治疗;治疗组在对照组治疗基础上,服滋水分清饮;观察周期为3个月。观察结束后比较两组临床疗效并分析治疗组各证型血清胱抑素C等指标在治疗前后的变化。结果:总有效率治疗组为78.8%,对照组为50.0%,两组比较,差异有统计学意义(P<0.05);且糖尿病肾病患者随着病程进展,血清胱抑素C等指标呈增加趋势,与病情证型进展相符合;运用滋水分清饮干预后,阴阳两虚组症状缓解不明显,但各证型血清胱抑素C均有不同程度改善,尤其以气阴两虚、脾肾气虚组明显。结论:滋水分清饮能显著改善早期糖尿病肾病患者的临床症状,降低早期肾损害相关指标,尤其对于气阴两虚、脾肾气虚患者效果比较显著。

Objective：To observe the therapeutic efficacy of Zishui Fenqing decoction（for water supplement and clearing turbid urine） in treating various syndrome types of diabetic nephropathy and to preliminarily investigate the mechanism of the therapeutic efficacy.Methods：A total of 100 patients with diabetic nephropathy who met inclusion criteria were randomly divided into treatment group（n = 66） and control group（n = 34）.Both groups received conventional Western medicine treatment with antidiabetic and antihypertensive drugs in addition to diet control and exercise therapy;moreover,the treatment group was given Zishui Fenqing decoction.The observation period was 3 months.The treatment outcomes of the two groups were compared;for patients with different syndrome types of diabetic nephropathy in treatment group,the changes in serum cystatin C after treatment were analyzed.Results：The treatment group had a significantly higher response rate than the control group（78.8% vs 50.0%,P〈 0.05）.As diabetic nephropathy progressed,serum cystatin C increased in accordance with the development of syndrome types.After treatment with Zishui Fenqing decoction,the patients with the syndrome of yin-yang deficiency showed no significant improvement in symptoms,but variable improvement in serum cystatin C was seen in all syndrome types,especially deficiency of both qi and yin and spleen-kidney qi deficiency.Conclusion：Zishui Fenqing decoction can significantly relieve clinical symptoms and reduce early renal injury in patients with early diabetic nephropathy,especially those with deficiency of both qi and yin and spleen-kidney qi deficiency.