参芪地黄汤联合缬沙坦在气阴两虚型早期糖尿病肾病中的应用分析

Analysis on the Application of Shenqin Dihuang Decoction combined with Valsartan in Early Diabetic Nephropathy of Deficiency of Both Qi and Yin

目的观察参芪地黄汤联合缬沙坦在气阴两虚型早期糖尿病肾病(DN)中的应用效果。方法选取我院2014年1月—2016年1月收治的118例气阴两虚型早期DN患者,随机分为两组,各59例。两组均予基础治疗措施,对照组在此基础上口服缬沙坦胶囊,观察组在对照组基础上加用参芪地黄汤,比较两组疗效、治疗前后空腹血糖(FPG)、餐后2h血糖(2h PG)、尿白蛋白排泄率(UAER)、血清肌酐(SCr)、尿素氮(BUN)指标及中医症状积分变化,并评价安全性。结果两组患者治疗后FPG、2h PG、UAER、SCr、BUN指标均明显改善(P<0.01),观察组改善情况优于对照组(P<0.01)。治疗后两组中医症状积分均明显下降(P<0.01),观察组下降更显著(P<0.01)。与对照组的72.88%相比,观察组有效率为88.14%,明显更高(P<0.05)。两组均未出现严重不良反应,比较无统计学差异(P>0.05)。结论参芪地黄汤联合缬沙坦治疗气阴两虚型早期DN可明显降低蛋白尿,减轻临床症状,保护肾功能,安全可靠,有一定的临床应用价值。

Objective To observe the application effect of Shenqin Dihuang decoction combined with valsartan in early diabetic nephropathy （DN） of deficiency of both qi and yin. Methods Selecting 118 cases of early DN of deficiency of both qi and yin our hospital from January 2014 to January 2016, they were randomly divided into two groups, with 59 patients in each group. The two groups were given foundation treatment. The control group was also given oral valsartan capsules. The observation group was given Shenqin Dihuang decoction on the basis of the control group. The curative effect, fasting plasma glucose （FPG） before and after treatment, 2 h postprandial blood glucose （2 HPG）, urinary albumin excretion rate （UAER）, serum creatinine （SCr）, urea nitrogen （BUN） and TCM symptoms integral were compared, and safety evaluation was made. Results After treatment, FPG, 2 HPG, UAER, SCr and BUN index of the two groups were significantly improved （P 〈 0.01 ）, and the improvement of the observation group was superior to the control group （ P 〈 0. 01 ）. After treatment, TCM symptom score of the two groups were significantly decreased （P 〈 0.01 ） , and the observation group decreased more significantly （P 〈 0.01 ）. Comparing with the 72.88% of the control group, the effective rate of the observation group was 88.14% which was obviously higher （ P 〈 0.05 ）. No serious adverse reaction occurred in both groups, and there was no statistical difference （ P 〉 0. 05 ）. Conclusion Shenqin Dihuang decoction combined with valsartan in early DN of deficiency of both qi and yin can obviously reduce albuminuria, relieve the clinical symptoms, and protect renal function. It is safe and reliable, and has certain clinical value.