古方黄芪散治疗糖尿病肾病的临床疗效观察

Clinical Efficacy of Ancient Prescription Huangqisan in Treating Diabetic Nephropathy

目的:观察宋代典籍经验古方黄芪散对糖尿病肾病的临床疗效。方法:选取糖尿病肾病患者42例,在给予糖尿病常规治疗的基础上,给予古方黄芪散6 g,每日3次,以荤汤送服。观察4、8、12周24 h尿蛋白和血糖、血脂、肌酐和转氨酶水平。结果:糖尿病肾病患者治疗4周后24 h尿蛋白由(1.51±0.76)g降至(1.35±0.69)g,治疗8周时降至(1.21±0.68)g,治疗12周时降至(1.14±0.62)g。与治疗前比较,应用古方黄芪散治疗4、8、12周时患者24 h尿蛋白降低(P<0.01)。与治疗4周时比较,治疗8、12周糖尿病肾病患者24 h尿蛋白降低(P<0.01)。与治疗8周比较,治疗12周糖尿病肾病患者24 h尿蛋白降低(P<0.05)。治疗12周,尿蛋白下降幅度在30%左右。与治疗前比较,应用黄芪散治疗4、8、12周后患者空腹血糖及甘油三酯水平均有所降低(P<0.05),其中血糖下降幅度约为5.93%,甘油三酯下降幅度约为36.07%。除1例患者出现口角疱疹,1例患者出现一过性血压下降,2例患者出现睡眠障碍外,未发现其他与黄芪散相关的不良反应。结论:古方黄芪散可降低糖尿病肾病患者尿蛋白,对糖尿病肾病的治疗有较好的疗效。

Objective:To observe the clinical effects of ancient prescription huangqisan on diabetic nephropathy,which is the traditional chinese medicine treatment of diabetes in the Song Dynasty.Methods:42 cases of patients with diabetic nephropathy who were treated routine treatment of diabetes,were given huangqisan 6g,taking medicine with meat soup 3 times a day.The levels of urine protein and blood glucose,blood lipid,creatinine and transaminase were observed at 4,8,and 12 weeks.Results:At 4 weeks,the 24 h urinary protein decreased from(1.51±0.76)g to(1.35±0.69)g in patients with diabetic nephropathy,decreased to(1.21±0.68)g at 8 weeks,and(1.14±0.62)g at 12 weeks.After treated with huangqisan at 4,8 and 12 weeks,the 24 h urinary protein of the patients were significantly decreased compared with pretherapy(P<0.01).The 24 h urinary protein of the patients treated with huangqisan at 8 and 12 weeks decreased significantly compared with 4 weeks(P<0.01).The 24h urinary protein of the patients treated with huangqisan at 12 weeks decreased significantly compared with 8 weeks(P<0.01).After 12 weeks treatment,the decrease of urine protein was about 30%.Compared with those before treatment,the levels of fasting blood glucose and triglyceride were all decreased after treatment with huangqisan at 4,8 and 12 weeks(P<0.05),the blood sugar decreased about 5.93%and triglyceride decreased about 36.07%.No special adverse reactions related to huangqisan powder were found except for 1 case of tiff heres,1 case of transient hypotension and 2 cases of sleep disorders.Conclusion:Huangqisan can reduce proteinuria in the patients with diabetic nephropathy,has good curative effect in the treatment of diabetic nephropathy.