益肾化瘀通络法治疗Ⅳ期糖尿病肾病临床观察

Kidney-supplementing Blood Stasis-removing and Collateraldredging for Diabetic Nephropathy of Stage Ⅳ

目的:观察益肾化瘀通络法治疗Ⅳ期糖尿病肾病(diabetic nephropathy,DN)的临床疗效。方法:将68例气阴两虚、瘀血阻络证DN患者随机分为治疗组(44例)和对照组(24例),对照组在控制饮食、运动治疗基础上给予常规西药降压、降糖治疗,治疗组患者在对照组疗法基础上口服益肾化瘀通络方。治疗后观察两组临床疗效,治疗前后分别检测两组24 h尿蛋白、尿白蛋白排泄率、空腹血糖、糖化血红蛋白A1c、血清胱抑素C及血脂水平。结果:两组临床疗效比较,差异无统计学意义(P>0.05),治疗组在降低24 h尿蛋白、尿白蛋白排泄率、血清胱抑素C、甘油三脂、低密度脂蛋白胆固醇水平,升高高密度脂蛋白胆固醇水平方面显著优于对照组。结论:益肾化瘀通络法可降低Ⅳ期DN患者尿蛋白,促进肾小球滤过,调节血脂水平,从而延缓肾功能减退。

Objective：To observe the clinical efficacy of kidney-supplementing,blood stasis-removing and collateral-dredging（KBC）in treating diabetic nephropathy（DN）of stageⅣ.Methods：A total of 68 cases of stageⅣ DN patients with syndrome of both qi and yin deficiency,blood stasis and collateral obstruction were randomly divided into treatment group（44 cases）and control group（24 cases）.Patients in the control group were treated with antihypertensive agents and antidiabetic agents based on diet control and exercise therapy,and the patients in the treatment group were additionally treated with KBC therapy.After treatment,the clinical efficacies of both groups were observed and compared.Before and after treatment,the levels of urine protein within 24 h（24 hUP）,urinary albumin excretion rate（UAER）,fasting blood glucose（FBG）,glycosylated hemoglobin alpha 1c（HbA1c）,serum cystatin C（Cys-C）and blood lipids were assayed respectively in both groups.Results：There was no significant difference in clinical efficacy between the two groups（P0.05）.The decreased levels of 24 hUP,UAER,Cys-C,triglyceride,low density lipoprotein-cholesterol and increased levels of high density lipoprotein-cholesterol were significantly higher in the treatment group than those in the control group.Conclusion：KBC therapy can decrease the levels of urine protein,and promote the function of glomerular filtration,as well as regulate the levels of lipids,and thus delay the kidney function decline in patients with stage Ⅳ DN.