参芪地黄汤治疗早期糖尿病肾病35例临床观察

Clinical observation of Shenqi Dihuang decoction on 35 cases of early diabetic nephropathy

[目的]观察参芪地黄汤对早期糖尿病肾病(DN)患者的临床疗效。[方法]选取2014年10月—2015年9月期间在镇江市中医院肾病科及内分泌科门诊或住院部接受治疗的早期DN患者70例,将其按随机数字表法分为对照组和治疗组,每组35例。两组均给予基础治疗,治疗组加服加味参芪地黄汤,每次200 mL,每日3次,共6周。观察治疗前后临床症状、体征、血糖、血脂、肾功能、24 h尿蛋白等指标的变化。[结果]治疗组总有效率为94.3%,对照组总有效率为71.4%,治疗组在改善临床症状、中医证候疗效等方面均优于对照组;治疗后两组24 h尿蛋白、肌酐(Scr)、甘油三酯(TG)、总胆固醇(TC)均明显下降(P<0.05),治疗组下降更为显著(P<0.05);治疗后两组空腹血糖(FBG)、糖化血红蛋白(Hb A1c)均明显下降(P<0.05),但两组间无明显差异(P>0.05)。[结论]参芪地黄汤能有效改善DN患者症状体征,下调血糖血脂水平,减少尿白蛋白,从而起到早期防治DN的作用。

[Objective] To observe the clinical effect of Shenqi Dihuang decoction on early diabetic nephropathy（DN）. [Methods] Seventy patients with DN were randomly divided into the treatment group（35 cases）and the control group（35 cases）. All patients were treated with the diabetes basic treatment. Patients in the treatment group were given Shenqi Dihuang decoction 200 m L, three times a day. Both groups were treated for 6 weeks. Symptoms, signs, levels of fasting blood glucose（FBG） and renal function were detected before and after treatment. [Results] The total effective rate in treatment group reached 94.3%,which was much higher than 71.4% in control group. The clinical symptoms and effect of traditional Chinese medicine syndrome in treatment group had improved significantly. Urinary protein of24 hours,serum creatinine（Scr）, total cholestrol（TC） and triglyceride（TG） in the treatment group were all lower than before treatment and those of the control group at corresponding time points with statistical difference（P〈0.05）;FBG and Hb A1 c were significant lower than before treatment in both groups, but there was no significant difference between two groups（P〉0.05）. [Conclusion] Shenqi Dihuang decoction can improve the clinical symptoms and the level of blood glucose and blood lipid, decrease the urinary protein of 24 hours of patients of DN, to protect the kidney and delay the progress of DN.