自拟汤剂联合西医治疗糖尿病肾病合并高血压的中医证候及炎症改善分析

Analysis of TCM syndromes and the improvement of inflammation in the treatment of diabetic nephropathy combined with hypertension by self-made decoction combined with Western Medicine

目的:探讨自拟汤剂联合西医治疗糖尿病肾病合并高血压的中医证候及炎症改善情况。方法:选取我院2016年4月到2017年4月接诊的200例糖尿病肾病合并高血压患者进行研究,按照患者入院ID号尾号进行随机分组,将其均分为对照组和观察组。对照组采取西医治疗,观察组在对照组的基础上,采取益气活血汤治疗。对两组患者治疗后的中医症候积分、血压及肾功能指标以及治疗前后炎症因子超敏C-反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平进行比较。结果:观察组的脾肾不足、气阴两虚、神疲乏力、五心烦热、舌苔厚腻积分均明显低于对照组,DBP、SBP、SCr、UAER、BUN水平(74.33±7.54mmHg、122.54±10.62mmHg、60.61±6.84μmol/L、114.44±10.25μg/min、5.24±1.12mmol/L)均明显低于对照组(91.82±8.42mmHg、138.41±11.72mmHg、69.75±7.54μmol/L、137.86±12.16μg/min、6.37±1.25mmol/L),两组比较差异有统计学意义(P<0.05)。治疗前,两组患者的hs-CRP、IL-6、TNF-α比较差异不明显,无统计学意义(P>0.05)。治疗后,观察组hs-CRP、IL-6、TNF-α(1.85±0.75mg/L、25.34±3.78μg/L、16.11±3.15μg/L)均明显低于对照组(4.78±0.83mg/L、37.08±4.22μg/L、20.73±3.79μg/L),两组比较差异有统计学意义(P<0.05)。结论:采取自拟汤剂联合西医治疗糖尿病肾病合并高血压患者,能够有效的改善患者中医症候积分和炎症情况,值得临床上应用及推广。

Objective：To explore the TCM syndromes and the improvement of inflammation in the treatment of diabetic nephropathy combined with hypertension by the combination of self-made Decoction and Western medicine.Methods：200 cases of diabetic nephropathy combined with hypertension were studied in our hospital from April 2016 to April 2017,according to the number of the patients’ entrance number ID,the patients were randomly divided into the control group and the observation group.The control group was treated with western medicine, and the observation group was treated with Yiqi Huoxue Decoction on the basis of the control group.The TCM symptom score, blood pressure and renal function indexes and the levels of inflammatory factors, such as high sensitivity C-reactive protein（hs-CRP）, interleukin 6（IL-6） and tumor necrosis factor alpha（TNF-alpha）, they were compared between the two groups after treatment.Results The observation group of deficiency of spleen and kidney, deficiency of Qi and Yin, lassitude, Fanre, tongue thick and greasy scores were significantly lower than the control group, and the DBP, SBP, SCr, UAER and BUN（74.33±7.54 mmHg,122.54±10.62 mmHg,60.61±6.84 mol/L,114.44±10.25 g/min,5.24±1.12 mmol/L） were significantly lower than the control group（91.82±8.42 mmHg,138.41±11.72 mmHg,69.75±137.86±7.54 mol/L,12.16 g/min,6.37±1.25 mmol/L）,and the difference between the two groups was statistically significant（P〈0.05）.Before treatment, there was no significant difference in hs-CRP, IL-6 and TNF-alpha between the two groups, and there was no statistical significance（P〉0.05）.After treatment, the hs-CRP, IL-6 and TNF-alpha in the observation group（1.85±0.75 mg/L,25.34±3.78μg/L,16.11±3.15μg/L） were significantly lower than those in the control group（4.78±0.83 mg/L,37.08±4.22μg/L,20.73±3.79μg/L）, and the difference between the two groups was statistically significant（P〈0.05）.Conclusions：Taking self prescribed decoction combined with western medicine in the treatment of diabetic nephropathy complicated with hypertension can effectively improve TCM syndrome score and inflammatory condition, which is worthy of clinical application and promotion.