益气活血泄浊方治疗中晚期糖尿病肾病临床研究

Clinical Research on Yiqi Huoxue Xiezhuo Prescription Treatment of Middle-Late Diabetic Nephropathy

目的:观察益气活血泄浊方治疗糖尿病肾病(diabetic nephropathy,DN)的临床疗效。方法:45例Ⅲ~Ⅳ期DN患者随机分为对照组(常规治疗)、中药组(常规治疗+益气活血泄浊方)、肾衰宁组(常规治疗+肾衰宁颗粒),每组15例,2个月为1个疗程,共3个疗程,并随访2个月。结果:中药组治疗后,中医证候疗效及积分显著升高,24小时尿蛋白定量、尿微量白蛋白(urinary microalbumin,UAER)、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、空腹血糖(fasting blood-glucose,FBG)、餐后2小时血糖(2 hour postprandial blood glucose,2 h PG)、糖化血红蛋白水平(hemoglobin A1c,HbA1c)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白(low-density lipoprotein,LDLC)、转化生长因子β1(transforming growth factorβ1,TGF-β1)、尿单核细胞趋化蛋白-1(urine monocyte chemotactic protein 1,MCP-1)、肿瘤坏死因子(tumor necrosis factor alpha,TNF-α)、肾小球滤过率(glomerular filtration rate,GFR)、肾血浆流量(renal plasma flow,RPF)显著降低,高密度脂蛋白(high density lipoprotein,HDLC)显著升高,中药组以上指标与另外两组相比,差异均具有统计学意义(P<0.05),丙氨酸氨基转移酶(alanine aminotrnsferase,ALT)、天门冬氨酸氨基转移酶(aspartic aminotransferase,AST)、碱性磷酸酶(alkaline phosphatase,ALP)无显著性差异。结论:益气活血泄浊方治疗中晚期DN疗效显著,能够延缓病情,提高肾脏功能。

Object：To explore the functional mechanism of Yiqi Huoxue Xiezhuo Prescription treatment of diabetic nephropathy（DN）.Methods：Forty-five patients with Ⅲ-Ⅳ staging DN were enrolled.They were randomly divided into 3 groups：control group（routine treatment）,Chinese medicine group（routine treatment and Yiqi Huoxue Xiezhuo Prescription） and Shenshuaining group（routine treatment and Shenshuaining）.Each group of 15 cases,2 months as one period of treatment and the total of three treatment courses.Related treatments were determined at each treatment course and indexes were measured at 2 months follow-up.Results：After treatment,TCM curative effect and integral of Chinese medicine group significantly increased.24 h urine protein,urine microalbumin（UAER）,urea nitrogen（BUN）,serum creatinine（Scr）,fasting blood-glucose（FPG）,two hours postprandial blood glucose（2 hPG）,glycated hemoglobin levels（HbA 1c）,systolic pressure（SBP）,diastolic blood pressure（DBP）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDLC）,transforming growth factor-β1（TGF-β1）,monocyte chemoattractant protein-1（MCP-1）,tumor necrosis factor（TNF-α）,glomerular filtration rate（GFR）,renal plasma flow（RPF） decreased markedly.High-density lipoprotein（HDLC） increased dramatically.Compared with Shenshuaining and the control group,above index differences were statistically significant（P 0.05）.There was no difference in alanine aminotransferase（ALT）,aspartate aminotransferase（AST） and alkaline phosphatase（ALP）.Conclusion：Yiqi Huoxue Xiezhuo Prescription has a good effect on middle-late DN,which can delay patient＇s condition and has a certain advantages.