参芪地黄汤加减治疗气阴两虚血瘀证糖尿病肾病Ⅳ期临床研究

Clinical Study on Effect of Fuzheng Jiedu Tongluo Decoction in Treatment of Stage Ⅳ Diabetic Nephropathy of Type of Qi and Yin Deficiency and Blood Stasis Syndrome

目的:探讨参芪地黄汤加减治疗气阴两虚血瘀证糖尿病肾病Ⅳ期临床研究。方法:选取2016年5月—2017年12月医院收治的88例Ⅳ期DN患者,随机分为对照组与试验组,每组44例。对照组予常规基础治疗方案,试验组在上述基础上予给予扶正解毒通络汤治疗,均连续治疗12周。检测治疗前后血糖、血脂、肾功能指标以及血液流变学参数变化,同时比较临床效果。结果:与治疗前相比,对照组血糖指标FBG、2 hPG、HbA1C,血脂指标TG、TC、LDL-C、HDL-C,血液流变学参数无变化(P>0.05),试验组FBG、2hPG、HbA1C降低(P<0.01),TG、TC、LDL-C降低(P<0.01),HDL-C升高(P<0.01),全血黏度、血浆黏度、纤维蛋白原降低(P<0.01),两组UAIb、24hUAIb、UAIb/UCr降低(P<0.01);与对照组相比,试验组FBG、2hPG、HbA1C较低(P<0.01),TG、TC、LDL-C较低(P<0.01),HDL-C较高(P<0.01),UAIb、24hUAIb、UAIb/UCr较低(P<0.01),全血黏度、血浆黏度、纤维蛋白原较低(P<0.01),总有效率较高(P<0.01)。结论:参芪地黄汤加减治疗气阴两虚血瘀型Ⅳ期糖尿病肾病效果满意,显著减少尿白蛋白,其作用机制可能与调节糖脂代谢以及血液流变学有关。

Objective:To investigate the effect of Fuzheng Jiedu Tongluo decoction in the treatment of stageⅣdiabetic nephropathy of type of Qi and Yin deficiency and blood stasis syndrome.Methods:A total of 88 patients with stageⅣDN of type of Qi and Yin deficiency and blood stasis syndrome from 2016.5 to 2016.12 in our hospital were selected and randomly divided into two groups,44 cases in each.The control group received routine basic treatment,and the study group additionally received Fuzheng Jiedu Tongluo Decoction.All the patients were treated continuously for 12 weeks.The changes of blood glucose,blood lipid,renal function indexes and blood rheology parameters were detected before and after treatment,and the clinical effects were compared.Results:Compared with those before treatment,the indexes of blood glucose,FBG,2 hPG,HbA1 C,blood lipid index,TG,TC,LDL-C and HDL-C in the control group had not changed(P>0.05).Levels of FBG,2 hPG and HbA1 C in the study group decreased(P<0.01).Levels of TG,TC and LDL-C decreased(P<0.01),HDL-C increased(P<0.01),whole blood viscosity,plasma viscosity,fibrinogen decreased(P<0.01),UAIb,UAER,24 hUAIb and UAIb/UCr in two groups decreased(P<0.01).Compared with the control group,levels of FBG,2 hPG and HbA1C in the study group were lower(P<0.01),levels of TG,TC,LDL-C were lower(P<0.01),HDL-C was higher(P<0.01),levels of UAIb,UAER,24 hUAIb and UAIb/UCr were lower(P<0.01),whole blood viscosity,plasma viscosity and fibrinogen the original were lower(P<0.01).The total efficiency was higher(P<0.01).Conclusion:Acupuncture combined with Fuzheng Jiedu Tongluo Decoction was effective on blood stasis typeⅣdiabetic nephropathy and it can significantly reduce urinary albumin.Its mechanism may be related to the regulation of lipid metabolism and hemorheology.