益气养阴活血方对糖尿病肾病临床疗效及对患者肾脏保护作用研究

Clinical Therapeutic Effects of Yiqi Yangyin Huoxue Formula on Diabetic Nephropathy and the Protective Role of the Kidney in the Patients

目的探讨糖尿病肾病(DN)应用益气养阴活血方治疗的临床效果及对患者肾脏保护作用。方法选取我院2013年1月—2014年12月收治的134例DN患者,依据随机数字表法均分为两组。所有患者均给予常规基础治疗,对照组予以盐酸贝那普利治疗;治疗组在对照组基础上,采用益气养阴活血方治疗。记录比较两组中医证候疗效,治疗前后血液流变学指标、肾功能指标及血清炎症因子水平,并观察用药期间不良反应发生情况。结果经3个月治疗后,治疗组中医证候总有效率显著高于对照组,差异有统计学意义(P<0.01)。两组治疗后高切全血黏度(WBV)、低切WBV、纤维蛋白原(FIB)、血浆黏度(PV)及红细胞比容(Hct),均显著低于治疗前,差异有统计学意义(P<0.01);与对照组同期比较,治疗组治疗后血液流变学指标改善幅度均更为显著,差异有统计学意义(P<0.01)。与治疗前比较,两组治疗后糖化血红蛋白(HbAlc)、空腹血糖(FPG)、尿白蛋白排泄率(UAER)及尿素氮(BUN),均显著降低,差异有统计学意义(P<0.01);且治疗组治疗后生化指标改善效果均显著优于对照组同期,差异有统计学意义(P<0.01)。两组治疗后血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)水平,均显著低于治疗前,差异有统计学意义(P<0.01);与对照组同期比较,治疗组治疗后血清炎症因子水平改善程度均更为显著,差异有统计学意义(P<0.01)。治疗组治疗期间不良反应率为3.0%与对照组的6.0%比较,差异无统计学意义(P>0.05)。结论早期DN患者应用益气养阴活血方治疗更能迅速缓解其临床症状,改善机体血液流变学,调节糖代谢紊乱,降低炎症水平,改善患者肾功能,减少尿蛋白的排出。

Objective To observe the therapeutic effects of yiqi yangyin huoxue formula on diabetic nephropathy（ DN） and the protective role of the kidney in the patients. Methods From January 2013 to December 2014,134 patients of DN were collected and divided into two groups according the random number table. The conventional basic treatment was used in all of the patients. In the control group,benazepril hydrochloride was used. In the treatment group,besides the treatment as the control group,yiqi yangyin huoxue formula was added. TCM therapeutic effects,hemorheological indexes,kidney function indexes and serum inflammatory factors were recorded and compared before and after treatment in the two groups. The adverse reactions were observed during the medication. Results After 3-month treatment,the total effective rate for TCM syndrome in the treatment group was higher significantly than the control group,indicating the significant difference（ P 0. 01）. After treatment,the hi-cut WBV,low-cut WBV,FIB,PV and Hct were all lower significantly than those before treatment in the two groups,indicating the significant differences（ P 0. 01）. Compared with the control group at the same period,the improvements in the hemorheological indexes were more significant in the treatment group after treatment,indicating the significant differences（ P 0. 01）.Compared with those before treatment,HbAlc,FPG,UAER and BUN were all reduced significantly after treatment in the two groups,indicating the significant differences（ P 0. 01）. The improvements in the biochemical indexes in the treatment group were significant as compared with the control group at the same stage after treatment,indicating the significant difference（ P 0. 01）. After treatment,the levels of hs-CRP and TNF-α were lower significantly than those before treatment in the two groups,indicating the significant difference（ P 0. 01）. Compared with the control group at the same stage,the improvement in the serum inflammatory factors in the treatment group was more significant after treatment,indicating the significant difference（ P 0. 01）. The incidence of adverse reactions was 3. 0% in the treatment group and was 6. 0% in the control group,without significant difference in comparison（ P 0. 05）. Conclusion The early application of yiqi yangyin huoxue formula rapidly relieves the clinical symptoms of DN,improves in hemorheology,regulates the disturbance of glucose metabolism,reduces inflammation,improves kidney functions and reduces urine protein.