芪苓补阳汤加味佐治老年糖尿病肾病合并慢性肾衰竭的效果观察

Effect of Jiawei Qiling Buyang Decoction in adjuvant treatment of geriatric diabetic nephropathy complicated with chronic renal failure

目的观察芪苓补阳汤加味佐治老年糖尿病肾病合并慢性肾衰竭(CRF)的临床效果。方法选择162例老年2型糖尿病肾病合并CRF患者,随机分为联合组82例和常规组80例。两组患者均给予常规治疗,常规组加服肾炎康复片治疗,联合组加服芪苓补阳汤治疗,疗程均为8周。比较两组治疗前、治疗后1个月的血糖水平、肾功能指标、免疫功能指标及治疗效果和不良反应发生率。结果治疗后,联合组患者空腹血糖、餐后2 h血糖、糖化血红蛋白、血肌酐、尿素氮、胱抑素C水平均低于治疗前及常规组,CD3^+、CD4^+和CD8^+T淋巴细胞占比均高于治疗前及常规组患者(均P<0.05)。联合组治疗总有效率为92.68%,常规组为81.25%,联合组疗效优于常规组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论芪苓补阳汤加味佐治老年糖尿病肾病合并CRF可更有效地降低血糖水平,减轻肾功能损伤,提高免疫功能,值得临床推广应用。

Objective To observe the clinical effect of Jiawei Qiling Buyang Decoction in the adjuvant treatment of geriatric diabetic nephropathy complicated with chronic renal failure(CRF).Methods A total of 162 elderly patients with type 2 diabetic nephropathy complicated with CRF enrolled were randomly divided into combination group(82 cases)and conventional group(80 cases).Both groups were given conventional treatment,the conventional group was treated with Shenyan Kangfu Pian additionally,whereas the combination group was treated with Qiling Buyang Decoction additionally,with the treatment course of 8 weeks in both groups.Blood glucose level,renal function indicators,immune function indicators as well as treatment effect and incidence rate of adverse reactions were compared between the two groups before and after treatment.Results After treatment,the combination group exhibited lower levels of FBG,2-hour postprandial blood glucose,and hemoglobin A1c,serum creatinine,blood urea nitrogen and cystatin C,and higher proportions of CD3^+,CD4^+and CD8^+as compared with pretreatment and the conventional group(all P<0.05).The total effective rate for treatment was 92.68%in the combination group and 81.25%in the conventional group,and the combination group was superior to the conventional group in efficacy(P<0.05).There was no statistically significant difference in incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Jiawei Qiling Buyang Decoction can effectively reduce blood glucose level,ameliorate renal impairment and improve immune function in the adjuvant treatment of geriatric diabetic nephropathy complicated with CRF,which is worthy of clinical promotion and application.