通络散结中药配方颗粒剂对Ⅲ期糖尿病肾病患者尿微量白蛋白、胱抑素C的影响

Effect of Tongluo Sanjie Chinese medical granules on urinary microalbumin and cystatin C in patients with stageⅢdiabetic nephropathy

目的观察通络散结中药配方颗粒剂对Ⅲ期糖尿病肾病(DN)患者尿微量白蛋白、胱抑素C(CysC)的影响。方法将2018年10月—2019年5月保定市第四中心医院收治的70例Ⅲ期DN患者按照随机数字表随机分为2组,每组35例,对照组给予常规西医治疗,观察组在对照组治疗的基础上接受通络散结配方颗粒剂治疗,疗程为12周。评估2组的临床疗效,观察2组治疗前后中医症状积分、血糖指标、血脂指标、肾功能指标变化。结果2组治疗后腰脊酸痛、面色晦暗、疲倦乏力、少气懒言、手足心热、食少纳呆、口中黏腻、头晕耳鸣、小溲黄赤积分与总积分均较治疗前明显降低(P均<0.05),治疗后观察组以上积分均低于对照组(P均<0.05)。2组治疗后空腹血糖(FPG)、2 h餐后血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Cr)、血尿素氮(BUN)、尿蛋白排泄率(UAER)、血浆CysC水平均较治疗前明显降低(P均<0.05),高密度脂蛋白胆固醇(HDL-C)、估算肾小球滤过率(eGFR)水平均较治疗前明显升高(P均<0.05),治疗后观察组以上指标改善情况均优于对照组(P均<0.05)。观察组临床疗效显著优于对照组(P<0.05)。结论通络散结中药配方颗粒剂可显著缓解Ⅲ期DN患者的临床症状,改善糖脂代谢紊乱,降低尿微量白蛋白与CysC含量,延缓并逆转肾功能恶化,其临床疗效优于单纯的西医疗法。

Objective It is to observe the effect of Tongluo Sanjie Chinese medical granules on urine microalbumin and Cys-C(Cys-C)in patients with stageⅢdiabetic nephropathy(DN).Methods Seventy patients with stageⅢDN admitted to the Fourth Central Hospital of Baoding City from October 2018 to May 2019 were randomly divided into 2 groups according to the random number table,35 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Tongluo Sanjie Chinese medical granules on the basis of therapy in the control group,both groups were treated for 12 weeks.The clinical efficacy of the 2 groups was evaluated,and the changes of TCM syndrome scores,blood glucose indexes,blood lipid indexes,and renal function indexes of the 2 groups were observed before and after treatment.Results After treatment,the scores of back ache,gloomy complexion,fatigue,lack of energy and laziness,feverishness in palms and soles,poor appetite,mouth stickiness,dizziness and tinnitus,deep-colored urine and the total scores were significantly decreased compared with before treatment in the 2 groups(P<0.05),the scores of the observation group were lower than those of control group after treatment(P<0.05).The levels of fasting plasma glucose(FPG),2 h postprandial plasma glucose(2hPG),insulin resistance index(HOMA-IR),glycosylated hemoglobin(HbA1c),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),blood creatinine(Cr),blood urea nitrogen(BUN),urinary protein excretion rate(UAER),plasma Cys-C were significantly lower while the level of high-density lipoprotein cholesterol(HDL-C))and estimated glomerular filtration rate(eGFR)were significantly higher after treatment than those before treatment in the 2 groups(P<0.05),and the improvements of the above indicators in the observation group were better than those in the control group after treatment(P<0.05).The clinical efficacy of the observation group was significantly better than that of the control group(P<0.05).Conclusion Tongluo Sanjie Chinese medical granules can significantly relieve the clinical symptoms,improve glucose and lipid metabolism disorder,reduce the contents of urine microalbumin and Cys-C,delay and reverse the deterioration of renal function in patients with stageⅢDN,and its clinical efficacy is better than the treatment with simple western medicine.