济生肾气丸加减治疗脾肾阳虚型糖尿病肾病的疗效观察

Observation on efficacy of addition and subtraction of Jisheng Shenqi pill on diabetic nephropathy of spleen-kidney and yang deficiency type

目的探讨济生肾气丸加减治疗脾肾阳虚型糖尿病肾病的疗效及对肾功能的影响。方法 86例脾肾阳虚型糖尿病肾病患者,采用随机法分为对照组和观察组,每组43例。对照组使用常规西医治疗,观察组在对照组基础上使用济生肾气丸加减治疗。观察比较两组患者临床疗效以及肾功能变化情况。结果观察组总有效率为95.35%高于对照组的76.74%,差异有统计学意义(P<0.05);观察组空腹血糖(FBG)为(7.06±1.48)mmol/L、餐后2 h血糖(2 h PBG)为(8.28±1.56)mmol/L、24 h蛋白尿定量为(144.18±9.78)mg低于对照组的(8.43±1.56)mmol/L、(9.59±2.41)mmol/L、(188.46±9.52)mg,而肌酐清除率(Ccr)为(42.01±4.36)ml/min高于对照组的(35.41±3.91)ml/min,差异有统计学意义(P<0.05)。观察组肢体浮肿、便溏、乏力和夜尿频多等中医症状积分明显低于对照组,差异有统计学意义(P<0.05)。结论针对脾肾阳虚型糖尿病患者,常规西医治疗效果欠佳,结合济生肾气丸加减治疗却可明显改善临床效果,促进患者康复,提升患者肾脏功能,值得广泛推广。

Objective To discuss the effect of addition and subtraction of Jisheng Shenqi pill on diabetic nephropathy of spleen-kidney and yang deficiency type and its influence on renal function. Methods A total of 86 patients with diabetic nephropathy of spleen-kidney and yang deficiency type were divided by random method into control group and observation group, with 43 cases in each group. The control group received conventional Western medicine therapy, and the observation group received addition and subtraction of Jisheng Shenqi pill on the basis of the control group. The clinical efficacy and renal function changes between the two groups was observed and compared. Results The observation group had higher total effective rate as 95.35% than 76.74% in the control group, and the difference was statistically significant （P〈0.05）. The observation group had lower fasting blood glucose （FBG） as （7.06 ± 1.48） mmol/L, postprandial 2 h blood glucose （2 h PBG） as （8.28 ± 1.56） mmol/L and 2d-hour proteinuria as （144.18 ± 9.78） mg than （8.43 ± 1.56）mmol/L, （9.59 ± 2.41） mmol/L and（188.46 ± 9.52） mg in the control group, and higher creatinine clearance （CCr） as （42.01 ± 4.36） ml/min than （35.41 ± 3.91） ml/min in the control group. Their difference was statistically significant （P〈0.05）. The observation group had obviously lower symptoms integral of edema, loose stools, fatigue, and frequent night urination than the control group, and their difference was statistically significant （P〈0.05）. Conclusion For patients with diabetic nephropathy of spleen-kidney and yang deficiency type, conventional western medicine treatment is not effective, but combining with Jisheng Shenqi pill can significantly improve the clinical effect, promote the recovery of patients, improve the renal function of patients. It is worthy of widespread promotion.