中西医结合治疗早期气阴两虚型糖尿病肾病的临床疗效及对改善肾脏微循环和保护肾脏功能的价值

Clinical efficacy of combination of traditional Chinese and western medicine in early diabetic nephropathy in type of Qi and Yin deficiency and the value of improving renal microcirculation and protecting renal function

目的探讨中西医结合治疗早期气阴两虚型糖尿病肾病的临床效果及对患者肾脏微循环的改善和肾功能的保护作用。方法选择2016年1月至2017年6月在我院接受治疗的136例早期气阴两虚型糖尿病肾病患者作为研究对象,随机分为对照组和观察组,各68例。对照组采用单纯西药治疗,观察组在此基础上加用参芪地黄汤治疗。比较两组患者临床疗效及治疗前后空腹血糖(FBP)、糖化血红蛋白(Hb A1c)、血清肌酐(SCr)、尿素氮(BUN)、24 h尿微量白蛋白(UAER)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、中医证候积分等。结果观察组患者的治疗总有效率为89.70%,高于对照组的73.53%,差异具有统计学意义(P<0.05)。治疗后,两组患者的FBP、Hb A1c、SCr、BUN、UAER、NAG水平与平均中医证候积分均显著降低,且观察组显著低于对照组(P<0.05)。结论中西医结合可提高糖尿病肾病临床疗效,改善肾微循环,保护肾功能,临床可借鉴推广。

Objective To explore the clinical effect of integrated traditional Chinese and western medicine on earlydiabetic nephropathy in type of Qi and Yin deficiency and the value of improving renal microcirculation and protectingrenal function. Methods A total of 136 patients with early diabetic nephropathy in type of Qi and Yin deficiency treatedin our hospital from January 2016 to June 2017 were selected and randomly divided into control group and observationgroup, with 68 cases in each group. The control group was treated with pure western medicine treatment, and theobservation group was treated with Shenqi Dihuang decoction on this basis. The clinical curative effects, levels of fastingblood glucose （FBP）, glycosylated hemoglobin （HbA1c）, serum creatinine （SCr）, urea nitrogen （BUN）, 24h urinemicroalbumin （UAER）, urinary N-acetyl-茁-D-glucosaminidase （NAG） and TCM syndrome scores before and aftertreatment were compared in the two groups. Results The total effective rate of treatment in the observation group was89.70%, which was significantly higher than 73.53% of the control group （P〈0.05）. After treatment, the levels of FBP,HbA1c, SCr, BUN, UAER, NAG and average TCM syndrome scores in the two groups significantly decreased, and thosein the observation group were significantly lower than the control group （P〈0.05）. Conclusion The combination of traditionalChinese and western medicine can improve the clinical effect of diabetic nephropathy, improve renal microcirculation andprotect the renal function, which can be used for clinical reference.