中药口服联合灌肠治疗糖尿病肾脏疾病疗效观察

Clinical effect observation of Chinese herbs oral and enema therapy in diabetic kidney disease

目的:观察中药口服联合灌肠治疗糖尿病肾脏疾病(DKD)的临床疗效。方法:将100例DKD患者采用随机数表法分为对照组、治疗组,每组50例。对照组采用西医常规降血糖治疗,治疗组在对照组基础上加用中药口服金匮肾气丸加减联合自拟中药灌肠的方法。观察两组治疗前后血肌酐(Scr)、尿素氮(BUN)、胱抑素C(Cy s C)、预估肾小球滤过率(eG FR)、空腹血糖(FPG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1C)、每日胰岛素总量的变化。结果:对照组治疗后FP G、2 h P G、H bA1C较治疗前均显著下降(P<0.05),治疗组治疗后Scr、BUN、CysC、FPG、2 hPG、HbA1C较治疗前均显著下降(P<0.05),治疗组治疗后eGFR较治疗前显著升高(P<0.05)。且治疗后,治疗组Scr、BUN、CysC、FPG、2 hPG、HbA1C、每日胰岛素总量较对照组显著下降(P<0.05),治疗组eGFR较对照组显著升高(P<0.05)。治疗组不良反应率显著低于对照组(P<0.05)。结论:中药口服联合灌肠治疗DKD,既能改善肾功能,又能很好地控制血糖、减少胰岛素用量,值得临床应用推广。

Objective:To observe clinical effect of Chinese herbs oral and enema therapy in diabetic kidney disease(DKD).Methods:A total of 100 DKD patients were divided into control group and treatment group by random numerical table method,50 patients in each group,the control group was treated with conventional hypoglycemic treatment of Western medicine,the treatment group was treated with modified Jingui Shenqi Pill orally and enema therapy on the basis of the control group.The serum creatinine(Scr),blood urea nitrogen(BUN),cystatin C(CysC),estimated glomerular filtration rate(eGFR),fasting plasma glucose(FPG),postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1C)and daily insulin dose were compared between two groups after treatment.Results:After treatment,FPG,2 hPG and HbA1C in the control group were significantly decreased compared with before treatment(P<0.05),Scr,BUN,CysC,FPG,2 hPG and HbA1C in the treatment group were significantly decreased after treatment compared with before treatment(P<0.05),and eGFR in the treatment group was significantly increased after treatment compared with before treatment(P<0.05).After treatment,Scr,BUN,CysC,FPG,2 hPG,HbA1C and daily insulin dosage in the treatment group were significantly decreased compared with the control group(P<0.05),and eGFR in the treatment group was significantly increased compared with the control group(P<0.05).Adverse reaction rate of the treatment group was decreased compared with the control group(P<0.05).Conclusion:Chinese herbs oral and enema therapy has significant effect on DKD,and it could improve renal function and reduce blood glucose and daily insulin dose,which is worthy of clinical application and promotion.