生脉散合归脾汤对2型糖尿病急性肾损伤气阴两虚证的治疗作用及机制研究

Study on Clinical Effect and Mechanism of Shengmai San and Guipi Tang on Type 2 Diabetes Mellitus Patients with Acute Kidney Injury for Deficiency of Qi and Yin

目的探讨生脉散合归脾汤对2型糖尿病(T2DM)急性肾损伤气阴两虚证的治疗作用及机制。方法将120例T2DM急性肾损伤气阴两虚证患者随机分为对照组和观察组各60例;两组患者均给予饮食控制等基础治疗,对照组在基础治疗基础上给予盐酸二甲双胍片和盐酸贝那普利,观察组在对照组基础上加服生脉散合归脾汤。比较两组患者的临床疗效、中医证候评分、血糖、炎症因子、肾功能、血液流变学、症状和体征消失时间及安全性。结果观察组治疗总有效率高于对照组(P<0.05);治疗后,观察组患者的各中医证候评分均低于对照组(P<0.05);观察组的症状和体征消失时间均少于对照组(P<0.05);观察组的血糖、肾功能、炎症因子及血液流变学指标均明显优于对照组(P<0.05);两组未见明显不良反应发生。结论生脉散合归脾汤治疗T2DM急性肾损伤气阴两虚证患者疗效明显,可能与改善血液流变学和肾功能,减少蛋白尿有关,安全性高。

Objective To explore the clinical effect and mechanism of Shengmai San and Guipi Tang on Type 2 Diabetes Mellitus(T2DM)patients with acute kidney injury for deficiency of qi and yin.Methods120 T2DM patients with acute kidney injury for deficiency of qi and yin are randomly divided into control group(60 cases)and observation group(60 cases);the control group is given metformin hydrochloride tablets and benazepril hydrochloride while the observation group is given Shengmai San and Guipi Tang.The clinical efficacy,TCM syndrome score,blood glucose level,renal function index,inflammatory factor level,hemorheology index,symptom disappearance time,and safety evaluation are compared between the two groups.Results The total effective rate of the observation group is significantly higher than which of the control group(P<0.05);after treatment,the scores of all TCM syndromes of the observation group are lower than those of the control group(P<0.05);the disappearance time of symptoms and signs are shorter than which of the control group(P<0.05);the blood glucose,renal function,inflammatory factors and hemorheological indexes of the observation group are significantly better than those of the control group(P<0.05);no obvious adverse reactions are observed in the two groups.Conclusion Shengmai San and Guipi Tang has significant effect on T2DM patients with acute kidney injury for deficiency of qi and yin,which may be related to improving hemorheology and renal function,reducing proteinuria,and has good safety.