健脾益肾宣肺利水方对Ⅳ/Ⅴ期糖尿病肾病水肿患者水肿程度和肾功能的影响

Effects of the Jianpi Yishen Xuanfei Lishui Formula on the severity of edema and renal function in patients with stageⅣ/Ⅴdiabetic nephropathy with edema

目的观察Ⅳ/Ⅴ期糖尿病肾病水肿患者实施健脾益肾宣肺利水方治疗的效果及对水肿程度和肾功能的影响。方法选择2019年1月至2020年11月北京中医医院怀柔医院内分泌科收治的60例Ⅳ/Ⅴ期糖尿病肾病水肿患者,随机分为对照组(n=30)和试验组(n=30)。对照组给予缬沙坦胶囊+常规利尿药物治疗,试验组在对照组基础上联合健脾益肾宣肺利水方治疗。比较两组患者临床疗效、肾功能、水肿评分和中医证候评分、生活质量。结果治疗后试验组肾功能24 h尿蛋白、血尿素氮(BUN)、血肌酐(Scr)均低于对照组,差异有统计学意义(P<0.05);治疗后试验组水肿、中医证候评分均低于对照组,差异有统计学意义(P<0.05);试验组临床治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后试验组社会功能、躯体功能、物质生活、心理功能评分高于对照组,差异有统计学意义(P<0.05)。结论Ⅳ/Ⅴ期糖尿病肾病水肿患者实施健脾益肾宣肺利水方治疗效果显著,能有效改善患者肾功能,减轻水肿等临床症状,提高患者生活质量。

Objective To observe the efficacy of Jianpi Yishen Xuanfei Lishui Formula and its effects on the severity of edema and renal function of patients with stageⅣ/Ⅴdiabetic nephropathy with edema.Methods A total of 60 patients with stageⅣ/Ⅴdiabetic nephropathy with edema admitted to the Department of Endocrinology,Huairou Hospital of Beijing Traditional Chinese Medicine Hospital from January 2019 to November 2020 were randomly divided into the control group(n=30)and the experimental group(n=30).The control group was treated with valsartan capsule+conventional diuretic drugs,while the experimental group was treated with Jianpi Yishen Xuanfei Lishui Formula on the basis of the treatment in the control group.The clinical efficacy,renal function,edema score and score of traditional Chinese medicine(TCM)syndromes,as well as quality of life of patients were compared between the two groups.Results The levels of renal function indicators such as 24-h urine protein,blood urea nitrogen(BUN)and serum creatinine(Scr)in the experimental group were lower than those in the control group after treatment,with statistically significant differences(P<0.05).The edema score and TCM syndrome score in the experimental group were lower than those in the control group after treatment,with statistically significant differences(P<0.05).The total effective rate of clinical treatment in the experimental group was higher than that in the control group,with statistically significant d i f f e r e n c e(P<0.05).The scores in social function,physical function,material life and psychological function of the experimental group were higher than those of the control group after treatment,with statistically significant differences(P<0.05).Conclusion The Jianpi Yishen Xuanfei Lishui Formula is significantly effective in the treatment of patients with stageⅣ/Ⅴdiabetic nephropathy with edema,which can effectively improve the renal function of patients,relieve edema and other clinical symptoms,and improve the quality of life of patients.