中药膏方治疗常规西药治疗效果不佳的老年糖尿病肾病患者的临床疗效观察

Clinical observation of the efficacy of Herbal Paste in elderly DKD patients

目的观察中药膏方治疗常规西药治疗效果不佳的老年糖尿病肾病(DKD)(Ⅲ、Ⅳ期)患者的临床疗效。方法将80例常规西药治疗效果不佳的老年糖尿病肾病(Ⅲ、Ⅳ期)患者随机分为对照组和治疗组,每组40例。对照组在常规降尿蛋白、改善肾功能等西药治疗基础上加用中药煎剂治疗,观察组在常规西药治疗基础上加用中药膏方治疗。观察两组治疗前后尿蛋白与肌酐比值(ACR)、尿白蛋白排泄率(UAER)、肾小球滤过率(GFR)和24 h尿蛋白水平,同时评定中医证候积分,并比较两组治疗总有效率、中药总费用及脱失率。结果治疗后两组ACR、UAER、GFR和24 h尿蛋白定量、中医证候积分分别与治疗前比较,差异有统计学意义(P<0.05),且治疗后观察组ACR、UAER、GFR、24 h尿蛋白定量和中医证候积分改善优于对照组(P<0.05),观察组总有效率、总费用及脱失率与对照组比较,差异有统计学意义(P<0.05)。结论中药膏方治疗老年糖尿病肾病(Ⅲ、Ⅳ期)患者疗效明显,且患者依从性好,花费低,值得临床推广应用。

[Abstraetl Objective After traditional medicine therapy, to observe the clinical effect of Herbal Paste in treating elderly patients with ineffective DKD （diabetic kidney disease） on stages of Ⅲ and IV. Methods After traditional western medicine therapy （such as reducing albumin and rehabilitating renal function）, a randomized study was used, 80 elderly patients with ineffective DKD on stages of Ⅲ and IV were enrolled in our study. Them were divided into control group and treatment group （n =40, each）. The control group was treated with Herbal Decoction, the treatment group was given with Herbal Paste. ACR （albumin/creatinine ratio）, UAER （urine albumin execretion rate）, GFR （glomerular filtration rate）, 24 hour urine protein and treatment symptom score of TCM （traditional chinese medicine） were observed before and after 4 months treatment, and compared the total TCM effective rate, the total herbal cost and the loss rate after therapy. Results There were statistical differences （P〈 0.05） in ACR, UAER, GRF, 24 hour urine protein and treatment symptom score of TCM before and after 4 months treatment, there were statistical differences （P〈 0.05） in ACR, UAER, GRF, 24 hour urine protein and treatment symptom score of TCM in control group versus treatment group, and there were statistical dif- ferences （P 〈 0.05） in the total TCM effective rate, the total herbal cost and the loss rate between two groups. Conclusion Herbal Paste had significangt effect on elderly patients with ineffective DKD on stages of III and IV, and it was worthy of clinical use for the better compliance and lower cost.