中药糖通饮方治疗早期糖尿病肾病患者临床观察

Clinical observation of Tang Tongyin prescription in TCM for patients with early diabetic nephropathy

[目的]通过观察中药糖通饮方对早期糖尿病肾病(DN)患者各指标的影响,评估其临床药物安全可靠性,系统量化评价其临床疗效,初步探讨其可能的作用机制,为防治DN提供一种安全、经济、有效的中药处方。[方法]将100例早期DN患者按随机数字表法随机分为对照组50例、治疗组50例,分别予以相应的方法治疗3个月,同时检测治疗前后患者各指标。[结果]两组治疗前后的血常规(BRT)、大便常规(SRT)、小便常规(URT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)、间接胆红素(IBIL)、直接胆红素(DBIL)、肌酐(Scr)、血清尿素氮(BUN)和γ-谷氨酰转肽酶(GGT)无变化(P>0.05)。两组治疗前后的血浆血管内皮生长因子(VEGF)、尿微量白蛋白/肌酐(Alb/Cr)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2HBG)、血清胰岛素(Insulin)均有不同程度的下降,内生肌酐清除率(Ccr)升高,差异有统计学意义(P<0.05或P<0.01)。治疗组较对照组VEGF、Alb/Cr、FBG、2HBG、HbA1c下降,Ccr升高,差异有统计学意义(P<0.05)。[结论]中药糖通饮方临床药物安全可靠,其对早期DN患者的肾脏病变有一定的保护作用,值得临床推广。

[Objective] To observe the influence of traditional Chinese medicine Tang Tongyin（TTY）on indexes of patients with early diabetic nephropathy, evaluate the drug safety and reliability of the prescription system clinically, quantitatively evaluate the clinical effect in treating diabetic nephropathy （DN） and explore its possible mechanism for providing a safe, economic, effective prescription of TCM in preventing and treating DN. [Methods] The 100 patients were randomly divided into two groups treating everyone with corresponding methods： the control group（50 cases） and the treatment group （50 cases）. At the same time the indicators of patients were detected before and after treatment. [Results] After treatment, BRT, SRT, URT, AST, ALT, ALP, TBIL, IBIL, DBIL, Scr, BUN and GGT of two groups were not changed （/9〉0.05）. VEGF, Alb/Cr, HbAlc, FBG, 2HBG and Insulin of two groups were decreased after treatment when compared with that of before treatment. However, Ccr was increased after treatment compared with that before treatment （P〈0.05 or P〈0.01 ）. The VEGF, Alb/Cr, FBG, 2HBG, HbAlc and insulin of the treatment group were less than that of the control group. Ccr of the treatment group was increased compared with that of the control group（P〈0.05）.[Conclusion] TTY is safe and reliable, and it has protective some effects against kidney injury in patients with early stage DN, which is worth promoting clinically.