益肾敛精泄浊法治疗糖尿病肾病的临床疗效分析

Clinical Effect of Yishen Lianjing Xiezhuo Therapy in Treating DN

目的:观察益肾敛精泄浊法对肝肾阴虚、瘀血湿浊型糖尿病肾病患者的临床疗效。方法:选取门诊及病房肝肾阴虚、瘀血湿浊型糖尿病肾病患者96例,随机分为治疗组和对照组,每组各48例,两组患者均采用常规糖尿病基础治疗,对照组在常规治疗的基础上加用盐酸贝那普利片(洛汀新)10 mg,每日1次口服;治疗组在对照组治疗的基础上加用芪地降白汤,每日1剂,水煎分2次早晚温服,疗程3个月。分别于治疗前、后检测空腹血糖(FBG)、餐后2 h血糖(2 h PG)、肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)、白细胞介素-6(IL-6)、超敏C-反应蛋白(Hs-CRP)、24 h尿蛋白定量(24 h Upro)、尿白蛋白排泄率(UAER)。结果:治疗组与对照组治疗后综合疗效比较,治疗组总有效率为89.58%,对照组总有效率为66.67%,治疗组优于对照组(P<0.05);芪地降白汤治疗组患者治疗后24 h Upro、UAER、TNF-α、IL-18、IL-6、Hs-CRP表达水平均降低,优于对照组(P<0.05)。结论:芪地降白汤可以减少尿蛋白排泄,对糖尿病肾病具有显著保护作用,其机制可能与减轻肾脏的炎症损伤有关。

Objective:To observe the clinical effect of Yishen Lianjing Xiezhuo therapy in treating diabetic nephropathy(DN)of yin-deficiency of Liver and Kidney,and of blood stasis and turbid phlegm.Methods:96 DN patients met the inclusion criteria were randomly divided into the treatment group(n=48)and the control group(n=48).Both groups were given basic treatment for diabetes.The control group was treated with Benazepril;on which basis,the treatment group was also treated with Qidi Jiangbai Decoction.The treatment duration was 12 weeks.Fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PG),tumor necrosis factor-α(TNF-α),interleukin-18(IL-18),interleukin-6(IL-6),hypersensitivity C-reactive protein(Hs-CRP),24-hour urine protein quantification(24-h Upro)and urinary albumin excretion rate(UAER)were observed before and after the treatment in the two groups.Results:The total effective rate of the treatment group was 89.58%,which was significantly higher than 66.67%of the control gruop(P<0.05).The levels of 24h-Upro,UAER,TNF-α,IL-18,IL-6,Hs-CRP were significantly lower in the treatment group than those in the control group(P<0.05).Conclusion:Qidi Jiangbai Decoction can reduce the excretion of urinary protein,and has a significant protective effect on DN.Its mechanism may be related to reducing the inflammatory damage of kidneys.