益气养阴活血通络方治疗糖尿病肾病的临床效果

Clinical effect of Supplementing Qi and Nourishing Yin, Activating Blood and Dredging Collaterals Prescription in the treatment of diabetic nephropathy

目的观察益气养阴活血通络方治疗糖尿病肾病的临床效果。方法选取2015年6月~2017年2月北京中医医院顺义医院收治的糖尿病肾病患者80例作为研究对象,并将其随机分为观察组(42例)和对照组(38例)。两组均给予临床常规治疗,对照组在此基础上给予缬沙坦胶囊80 mg/次,每天1次。观察组在对照组的基础上加用益气养阴活血通络方,每日1剂。两组均以12周为1个疗程。观察比较两组临床疗效和中医主要证候总积分。记录两组治疗前后各项肾功能指标[肾小球滤过率(GFR)、尿素氮(BUN)、血肌酐(Scr)、尿微量白蛋白(m Alb)、24 h尿蛋白定量]的变化情况。结果观察组临床疗效明显优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组和对照组中医主要证候总积分[(10.31±2.59)、(12.76±3.23)分]均较治疗前[(29.11±8.13)、(30.37±9.46)分]显著降低,且观察组治疗后中医主要证候总积分低于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组和对照组GFR[(80.54±11.36)、(75.86±9.72)m L/min]均较治疗前[(71.38±8.59)、(70.25±8.33)m L/min]显著升高,BUN[(6.14±0.52)、(6.83±0.76)mmol/L]、Scr[(91.5±16.2)、(102.6±19.8)μmol/L]、m Alb[(40.04±5.26)、(53.22±7.39)mg/L]、24 h尿蛋白定量[(0.73±0.05)、(0.95±0.09)g/24 h]均较治疗前[(7.81±0.95)、(7.92±1.06)mmol/L,(110.4±20.7)、(113.6±21.5)μmol/L,(89.03±18.15)、(86.56±17.11)mg/L,(1.57±0.16)、(1.59±0.23)g/24 h]显著降低,差异均有统计学意义(均P<0.05)。观察组治疗后GFR显著高于对照组,BUN、Scr、m Alb、24 h尿蛋白定量显著低于对照组,差异均有统计学意义(均P<0.05)。结论益气养阴活血通络方治疗糖尿病肾病能明显改善临床症状,减轻肾功能损伤,值得临床推广应用。

Objective To observe the clinical effect of Supplementing Qi and Nourishing Yin, Activating Blood and Dredging Collaterals Prescription in the treatment of diabetic nephropathy and the influence on inflammatory factors.Methods Eighty cases of patients with diabetic nephropathy admitted to Shunyi Hospital of Traditional Chinese Medicine from June 2015 to February 2017 were selected as research objects, and they were randomly divided into ob servation group（42 cases） and control group（38 cases）. Both groups were given clinical conventional treatment, on basis of which, the control group was given Valsartan Capsules 80 mg every time, once a day. The observation group was added with Supplementing Qi and Nourishing Yin, Activating Blood and Dredging Collaterals Prescription, one dose a day. Both groups took 12 weeks as a course. The clinical effect and the aggregate scores of main syndromes of traditional Chinese medicine of the two groups were observed and compared. The changes of renal function indexes[glomerular filtration rate（GFR）, blood urea nitrogen（BUN）, serum creatinine（Scr）, microalbuminuria（m Alb）, 24-hour urinary protein quantitation] of the two groups before and after treatment were recorded. Results The clinical effect of observation group was better than that of control group, the difference was statistically significant（P〈0.05）. After treatment, the aggregate scores of main syndromes of traditional Chinese medicine in observation group and control group [（10.31±2.59）,（12.76±3.23） points] were all lower than before treatment [（29.11 ±8.13）,（30.37 ±9.46） points], and the aggregate scores of main syndromes of traditional Chinese medicine of observation group after treatment were lower than those of control group, the differences were all statistically significant（all P〈0.05）. After treatment, the levels of GFR in observation group and control group [（80.54 ±11.36）,（75.86±9.72） m L/min] were all higher than before treatment [（71.38±8.59）,（70.25±8.33） m L/min], levels of BUN[（6.14 ±0.52）,（6.83 ±0.76） mmol/L], Scr [（91.5 ±16.2）,（102.6 ±19.8） μmol/L], m Alb [（40.04 ±5.26）,（53.22 ±7.39） mg/L],24-hour urinary protein quantitation [（0.73 ±0.05）,（0.95 ±0.09） g/24 h] were all lower than before treatment [（7.81 ±0.95）,（7.92±1.06） mmol/L;（110.4±20.7）,（113.6±21.5） μmol/L;（89.03±18.15）,（86.56±17.11） mg/L;（1.57±0.16）,（1.59±0.23） g/24 h], the differences were all statistically significant（all P〈0.05）, and the level of GFR after treatment in observation group was higher than that of control group, the levels of BUN, Scr, m Alb, 24-hour urinary protein quantitation were lower than those of control group, the differences were all statistically significant（all P〈0.05）. Conclusion Supplementing Qi and Nourishing Yin, Activating Blood and Dredging Collaterals Prescription in the treatment of diabetic nephropathy can significantly improve clinical symptoms, reduce renal injury, which is worthy of clinical promotion and application.