基于“先后天共养”理论治疗脾肾气阴两虚之糖尿病肾病的临床疗效

Treatment of Diabetic Nephropathy of Spleen and Kidney Deficiency and Qi and Yin Deficiency Based on the Theory of Congenital and Acquired Cohabitation

目的:观察基于“先后天共养”理论治疗脾肾气阴两虚之糖尿病肾病(DN)的临床疗效。方法:选取2018年10月至2019年4月期间辽宁中医药大学附属医院肾病科治疗的DN患者共100例作为研究对象,采用随机数表法随机分观察组和对照组,每组50例。对照组进行常规的西医基础性治疗如:控制血糖、改善肾血流等。观察组在对照组的基础上,予以补脾益肾方口服,每日1剂,由本院药方煎制成200 mL汤剂,分早晚2次口服。治疗时间15 d。观察2组治疗前后中医证候主症积分、肿瘤坏死因子-α(TNF-α)、血小板反应蛋白-1(TSP-1)、血肌酐(SCr)、尿微量白蛋白排泄率(UAER)水平及治疗后临床有效率情况。结果:治疗后,2组中医证候主症评分、TNF-α、TSP-1、SCr及UAER水平较治疗前均有所改善,且治疗后观察组明显优于对照组,差异有统计学意义(P<0.05)。治疗后对观察组治疗有效率为92%优于对照组治疗有效率的64%,差异有统计学意义(P<0.05)。结论:脾肾气阴两虚之糖尿病肾病在常规治疗基础上采用口服补脾益肾方可有效抑制炎性反应、提高肾小球滤过率、控制血糖、改善肾脏功能,提高临床疗效。

Objective:To explore the clinical efficacy of diabetic nephropathy(DN)with spleen and kidney deficiency and qi and yin deficiency based on the theory of“congenital and acquired cohabitation”.Methods:A total of 100 DN patients treated in the Department of Nephrology of Affiliated Hospital of Liaoning University of Traditional Chinese from October 2018 to April 2019 were selected as the research objects and randomly divided into a treatment group and a control group,with 50 cases in each group.The control group received basic Western medicine treatments such as controlling blood sugar and improving renal blood flow.On the basis of the control group,the treatment group was given oral Bupi Yishen Formula,1 dose per day.The decoction in our hospital was 200 mL per decoction,which was taken orally in the morning and in the afternoon.The treatment time was 15 days.Traditional Chinese medicine(TCM)symptom scores,TNF-α,TSP-1,SCr,UAER content and clinical effectiveness of the 2 groups were observed before and after treatment.Results:After treatment,the TCM symptom scores,TNF-α,TSP-1,SCr and UAER contents of the 2 groups were improved compared with those before treatment,and the treatment group was significantly superior than the control group after treatment,the difference was statistically significant(P<0.05).After treatment,the total clinical effective rate of the treatment group was 92%,which was superior than that of the control group of 64%,and the difference was statistically significant(P<0.05).Conclusion:DN with deficiency of spleen and kidney deficiency,qi and yin deficiency can effectively inhibit inflammation reaction,improve glomerular filtration rate,control blood sugar,improve renal function and improve clinical efficacy based on basic routine treatment.