温肾健脾、化瘀通络法治疗糖尿病肾病临床期

Wenshen Jianpi and Huayu Tongluo Methods in Treating Clinical-stage Diabetic Nephropathy

目的:观察温肾健脾,化瘀通络法对糖尿病肾病(DN)临床期的疗效。方法:将符合标准的DN患者50例,随机分为治疗组(25例)和对照组(25例),两组均予饮食控制、降糖等基础治疗,同时口服福辛普利10 mg,每日1次;治疗组在此基础上予以温肾健脾,化瘀通络的中药,疗程为12周。对患者的24 h尿蛋白(UP)定量,血肌酐(SCr),内生肌酐清除率(CCr),中医证候疗效等进行评价。结果:治疗组总有效率为80.0%,对照组总有效率为56.0%。治疗组明显优于对照组(P<0.05)。两组治疗后24 h尿蛋白定量均明显降低(P<0.05),组间比较,治疗组在降低24 h尿蛋白定量方面明显优于对照组(P<0.05);治疗组治疗后SCr显著降低(P<0.05),CCr显著升高(P<0.05);治疗组在改善肾功能方面明显优于对照组(P<0.05)。结论:温肾健脾,化瘀通络法能够有效的缓解和治疗临床期糖尿病肾病。

Objective： To observe the therapeutic effects of method for warming the kidney and strengthening the spleen,and dispersing blood stasis and promoting collaterals in the treatment of clinical-stage diabetic nephropathy（ DN）. Method： Fifty eligible DN patients were randomly divided into the treatment group（ 25 patients） and control group（ 25 patients）. Besides the routine therapy including controlling diet,lowing blood glucose and orally taking fosinopril（ 10 mg daily）,the treatment group was also given traditional Chinese medicine（ TCM） for warming the kidney and strengthening the spleen,and dispersing blood stasis and promoting collaterals for 12 weeks. The changes in quantitation of 24-hour urinary protein（ UP）,serum creatinine（ SCr）,endogenous creatinine clearance rate（ CCr）,TCM syndrome score were observed in the patients. Result： The total effective rate of the treatment group was 80. 0%,and that of control group was 56. 0%. The effect of treatment group was better than the control group in lowing 24 h UP（ P〈0. 05）,reducing SCr（ P〈0. 05）,increasing CCr（ P〈0. 05） and improving renal function（ P〈0. 05）. Conclusion： The method of warming the kidney and strengthening the spleen,and dispersing blood stasis and promoting collaterals can effectively abate and treat clinical-stage DN.