基于广义估计方程的益气通络方治疗早期糖尿病肾脏病临床疗效评价研究

Study on clinical efficacy of Yiqi Tongluo Decoction in patients with early diabetic kidney disease based on generalized estimating equations

目的运用广义估计方程评价益气通络方对早期糖尿病肾脏病患者的临床疗效。方法采用随机对照的方法将符合纳入标准的57例患者随机分为A组28例、B组29例,两组患者均给予基础治疗,A组给予益气通络方;B组给予厄贝沙坦片,进行12周随访观察,记录患者中医证候评分及24小时尿微量白蛋白排泄率等指标,采用广义估计方程对相关指标进行统计分析。结果与治疗前相比,A组和B组24小时尿微量白蛋白排泄率显著降低(P<0.05);A组中医证候积分较B组显著降低(P<0.05)。结论运用广义估计方程分析重复测量数据可靠、可行,益气通络方可有效降低早期糖尿病肾脏病患者24小时尿微量白蛋白排泄率、证候积分水平,且用药越久疗效越好,对早期糖尿病肾脏病有理想的防治作用。

Objective To observe the clinical efficacy of Yiqi Tongluo Decoction in patients with early diabetic kidney disease by using generalized estimating equations. Methods Randomized-controlled design was carried out. The selected 57 DN patients were randomized into group A of 28 cases and group B of 29 cases. On the basis of foundation treatment,patients in group A received Yiqi Tongluo Decoction while patients in group B were given Irbersartan oral treatment,with follow-up observatron for 12 weeks. The total score of TCM syndrome and 24-hour urinary albumin excretion rate were analyzed with generalized estimating equations methods. Results Comparing with those before treatment,24-hour urinary albumin excretion rate was significantly reduced in both group A and group B（ P〈0. 05）. The total score of TCM syndrome of group A significantly lower than group B（ P〈0. 05）. Conclusion Generalized estimating e- quations is reliable and feasible analyzing repeated data. Yiqi Tongluo Decoction can effectively reduce the 24-hour urinary albumin excretion rate and symptom integral level in patients with early diabetic kidney dis- ease,and the longer the prescription is being used the better treatment we can achieve which demonstrate i- deal effects on the prevention and treatment of early diabetic kidney disease.