温阳固肾化瘀方结合西医常规疗法治疗糖尿病肾病临床研究

Clinical study ofWenyang-Gushen-Huayu decoction on treating diabetic nephropathy

目的：评价温阳固肾化瘀方结合西医常规疗法治疗糖尿病肾病（diabetic nephrathy, DN）的临床疗效。方法选取蓬莱市中医院糖尿病科DN患者120例，按随机数字表法分为2组各60例，对照组给予西医常规疗法，观察组在对照组治疗基础上加用温阳固肾化瘀方。2组均治疗8周。观察2组治疗前后临床症状、体征的变化；采用生化分析法测定尿白蛋白排泄率（urinary albumin excretion rate,UAER），采用比色法测定24 h尿蛋白定量（24-upro, UP），评价临床疗效。结果观察组总有效率[93.34%（56/60）比73.33%（44/60）]高于对照组（χ2＝8.640，P＝0.003）。治疗后，观察组腰膝畏寒[（2.47±1.11）分比（2.92±1.36）分，t＝1.986]、面足浮肿[（1.81±0.96）分比（2.14±1.01）分，t＝5.165]、神疲乏力[（2.83±1.12）分比（3.51±1.18）分，t＝3.237]积分低于对照组（P＜0.05或 P＜0.01）；UAER[（326.4±98.7）μg/min 比（421.5±185.6）μg/min，t＝3.504]、UP[（0.7±0.33）g/24 h比（1.0±0.37）g/24 h，t＝1.845]均低于对照组（P＜0.01）。结论温阳固肾化瘀方结合西医常规疗法可有效改善DN患者临床症状、降低尿蛋白。

Objective To assess the clinical effectiveness ofWenyang-Gushen-Huayu decoction on treating diabetic nephropathy （DN）.Methods One hundred and twenty DN patients in Hospital of Penglai Chinese Medicine were included and randomly divided into treatment group and observation group. Both groups were given conventional treatment, and the treatment group was added withWenyang-Gushen-Huayu decoction. One course of treatment lasted four weeks in both groups and each group was observed for 2 courses. The clinical symptoms, vital signs, urinary albumin excretion rate （UAER）, and 24 h urinary proteinwere observed. Results The treatment group showed significantly higher effective rate （93.34%vs.73.33%） than that in the control groupa（χ2=8.640,P=0.003）. TheWenyang-Gushen-Huayu decoction significantly improved the symptoms of waist chills （2.47 ± 1.11vs.2.92 ± 1.36,t=1.986）, edema of face and feet （1.81 ± 0.96vs.2.14 ± 1.01,t=5.165）, fatigue of the gods （2.83 ± 1.12vs.3.51 ± 1.18,t=3.237）, UAER （326.4 ± 98.7μg/minvs. 421.5 ± 185.6μg/min;t=3.504） and UP （0.7 ± 0.33 g/24hvs. 1.0 ± 0.37 g/24h;t=1.845）.ConclusionsTheWenyang-Gushen-Huayu decoction could improve the symptoms and reduce UAER of DN patients.