肾芪1号方对早期糖尿病肾病胰岛素抵抗及尿微量白蛋白的影响

Effects of “Shenqi No.1 Prescription” on insulin resistance and urinary microalbumin in early diabetic kidney disease

目的观察肾芪1号方联合西医常规治疗早期糖尿病肾病的临床疗效。方法将89例早期糖尿病肾病患者随机分为治疗组(45例)与对照组(44例)。对照组予西医常规治疗,治疗组在对照组治疗措施基础上加服肾芪1号方治疗。两组疗程均为6个月,观察空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、胰岛素抵抗指数(Homa-IR)及尿微量白蛋白含量(m Alb)、血肌酐(Scr)、肾小球滤过率(e GFR)等指标的变化情况。结果 (1)治疗前后组内比较,治疗组2 h PG、Hb A1c、Homa-IR水平差异有统计学意义(P<0.05),对照组血糖各项指标水平差异无统计学意义(P>0.05)。组间治疗后比较,Homa-IR水平差异有统计学意义(P<0.05)。(2)治疗前后组内比较,治疗组m Alb水平差异有统计学意义(P<0.05)。组间治疗后比较,治疗组m Alb水平明显低于对照组(P<0.05)。结论在糖尿病肾病早期阶段采用肾芪1号方联合西医常规治疗,可改善胰岛素抵抗从而稳定血糖,保护肾脏功能,从而延缓疾病进展,改善患者的预后。

Objective To observe the clinical efficacy of＂Shenqi No.1 Prescription＂combined with routine treatment of western medicine in the treatment of early diabetic kidney disease（ DKD）.Methods 89 patients with early DKD patients were randomly divided into the treatment group（ 45 cases） and control group（ 44 cases）.The control group was treated with the routine treatment of western medicine,the treatment group was treated with＂Shenqi No.1 Prescription＂based on the treatment for the control group,with a course of 6 months.The changes on the indexes such as fasting plasma glucose（ FPG）,2 h postprandial glucose（ 2 h PG）,glycosylated hemoglobin（ Hb A1 c）,homeostasis model assessment of insulin resistance（ Homa-IR）,urinary microalbumin（ m ALB）,serum creatinine（ Scr） and glomerular filtration rate（ e GFR） were observed.Results（1）Compared with treatment before,there were statistically significant differences on the levels of 2 h PG,Hb A1 c and Homa-IR in the treatment group after treatment（ P〈0.05）,but no statistically significant differences on all the glycemic indexes in the control group were observed after treatment（ P〈0.05）.After treatment,there was statistically significant difference on Homa-IR level between the two groups（ P〈0.05）.（2）Compared with treatment before,there was statistically significant difference on the m ALB level in the treatment group after treatment（ P〉0.05）.After treatment,the m ALB level in the treatment group was obviously lower than that in the control group（ P〈0.05）.Conclusion ＂Shenqi No.1 Prescription＂combined with routine treatment of western medicine in the treatment of early diabetic kidney disease can improve the insulin resistance,stabilize the blood glucose,protect the renal function,and thus delay the disease progression and ameliorate the prognosis of patients.