参芪地黄汤加味联合氯沙坦治疗气阴两虚型糖尿病肾病临床研究

Clinical Study on Modified Shenqi Dihuang Tang Combined with Losartan for Diabetic Nephropathy of Deficiency of Both Qi and Yin Type

目的:观察气阴两虚型糖尿病肾病(DN)患者应用参芪地黄汤加味联合氯沙坦治疗的临床效果。方法:选取80例DN患者,按随机数字表法分为2组均40例。2组均接受糖尿病常规治疗措施;对照组服用氯沙坦,每次100mg,每天1次;治疗组在对照组治疗方案的基础上加服参芪地黄汤加味。连续治疗8周后,比较2组气阴两虚证症状评分、血糖水平、肾功能以及临床疗效。结果:治疗后,2组气阴两虚证症状评分显著减少(P<0.01);与对照组比较,治疗组治疗后气阴两虚证症状评分下降更明显(P<0.01)。治疗后,2组空腹血糖(FBG)、餐后2h血糖(P2hBG)、糖化血红蛋白(HbA1c)以及血肌酐(SCr)、24h尿总蛋白、24h尿清蛋白水平降低,差异均有统计学意义(P<0.01);与对照组比较,治疗组治疗后以上血糖及肾功能各项指标降低更明显,差异均有统计学意义(P<0.01)。总有效率治疗组87.50%,对照组65.00%,差异有统计学意义(P<0.05)。结论:参芪地黄汤加味联合氯沙坦治疗DN气阴两虚证的疗效确切。

Objective:To observe the clinical effect of modified Shenqi Dihuang tang combined with losartan for patients with diabetic nephropathy(DN)of deficiency of both qi and yin type.Methods:A total of 80 cases of DN patients were divided into two groups according to the random number table method,40 cases in each group.Both groups received routine treatment for diabetes;the control group was treated with losartan once a day for 100 mg,and the treatment group was additionally treated with modified Shenqi Dihuang tang based on the treatment of the control group.After treatment for eight weeks,the symptom scores of deficiency of both qi and yin syndrome,the levels of blood glucose,the kidney function and the clinical effect in the two groups were compared.Results:After treatment,the symptom scores of deficiency of both qi and yin syndrome in the two groups were significantly decreased(P<0.01);the decrease in the treatment group was more obvious than that in the control group(P<0.01).After treatment,the levels of fasting blood glucose(FBG),postprandial 2 h blood glucose(P2 hBG),hemoglobin A1 c(HbA1 c),serum creatinine(SCr),24-hour urinary albumin and 24-hour urine protein in the two groups were decreased,differences being significant(P<0.01);the decrease of the above indexes in the treatment group was more obvious than that in the control group,differences being significant(P<0.01).The total effective rate was 87.50%in the treatment group and 65.00%in the control group,the difference being significant(P<0.05).Conclusion:Modified Shenqi Dihuang tang combined with losartan has definite curative effect in treating DN with deficiency with both qi and yin syndrome.