中西医结合治疗对2型早期糖尿病肾病患者血糖、肾功能和生活质量的影响

Effects of Integrative Chinese and Western Medicine on Blood Glucose and Renal Function and Quality of Life in Patients with Type 2 Diabetic Nephropathy

目的观察中西医结合治疗对2型早期糖尿病肾病(DN)患者血糖、肾功能和生活质量(QOL)的影响。方法 124例早期DN患者随机分为西药组(n=62)和联合组(n=62),西药组给予传统西药和对症治疗,联合组额外给予自拟中药组方,治疗3个月后评价2组的空腹血糖(FPG)、餐后2h血糖(2hPG)、血清尿素氮(SUN)、血清肌酐(SCr)、24h尿白蛋白定量和不良反应,采用简易生活量表(SF-36)评价患者生活质量。结果 2组治疗后FPG、2hPG、BUN、SCr和24h尿白蛋白定量均明显降低(P<0.05)。治疗后2组BUN、SCr和24h尿白蛋白定量比较,P<0.05,但FPG、2hPG差异无统计学意义(P>0.05)。西药组和联合组不良反应发生率分别为20.97%和11.29%,有显著性意义(P<0.05)。2组治疗后SF-36量表的8个维度评分均明显增加(P<0.05),但联合组改变更明显,与西药组比较,P<0.05。结论对于早期DN,在传统西药治疗基础上,联合使用中药,可以明显改善患者的肾功能、降低尿蛋白含量、改善患者的生活质量、降低不良反应。

OBJECTIVE To investigate the effects of integrative Chinese and western medicine on blood glucose,renal function and quality of life （QOL） in patients with Diabetic nephropathy DN in order to supply strategy for the treatment of early DN.METHODS 124 cases with early DN were randomly divided into western medicine group （n=62） and integrative group （n =62）.The former were treated with western medicine and the latter were given Chinese medicine additionally for 3months.The levels of FPG,2hPG,SUN,SCr and 24 h urine albumin quantitative and adverse reaction were evaluated in both groups and the QOL were measured by SF-36Scale.RESULTS The levels of FPG,2hPG,SUN,SCr,and 24 h urine albumin quantitative were all significantly decreased after 3-month treatment than those in baseline （P＜0.05） of which only SUN,SCr,and 24 h urine albumin were showed significant differences between the two groups（P＜0.05）.The incidence of adverse reaction was 20 97％ in western medicine group,higher than 11.29％ in integrative group （P＜0.05） The scores in 8 fields of SF-36 Scale were all increased than baseline （P＜0.05）,but the integrative group changed more （P＜0.05）.CONCLUSION Integrative Chinese and western medicine can obviously improve the patient＇s kidney function,reduce urinary protein,improve the patient＇s quality of life and reduce the adverse reaction in the treatment of early DN.