玉泉丸汤剂联用坎地沙坦酯治疗糖尿病肾病的效果及对肾功能的影响

Effect of Yuquan Pill Decoction Combined with Candesartan Medoxomil in the Treatment of Diabetic Nephropathy and Its Effect on Renal Function

目的探讨在常规西医治疗基础上,辅助使用玉泉丸汤剂治疗的有效性、安全性,探讨联合方案对肾功能的影响。方法选取2019年5月至2020年5月河南省南阳市西峡县南阳豫西协和医院收治的糖尿病肾病患者(N=90),采用红绿双色球法将其分为对照组(绿色球,N=45)和观察组(红色球,N=45),比较观察组(联合方案)和对照组(单一西药)的肾功能、疗效和不良反应发生率。结果治疗后观察组的神疲乏力、少气懒言、自汗畏风、面色晦暗、腰脊酸痛、口黏欲饮、五心烦热、口干咽燥症候评分低于对照组,差异有统计学意义(P<0.05);治疗后观察组的尿微量白蛋白(mAlb)、尿白蛋白排泄率(UAER)、糖化血红蛋白(HbAlc)、一氧化氮(NO)、内皮素(ET)、肿瘤坏死因子(TNF-α)、白细胞介素-1(IL-1)水平低于对照组,差异有统计学意义(P<0.05);观察组治疗有效率高于对照组,差异有统计学意义(P<0.05);观察组安全性低于对照组,差异无统计学意义(P>0.05)。结论联合用药方案治疗糖尿病肾病,具有“疗效高、安全性尚可、肾功能改善明显”等优势。

Objective To investigate the efficacy and safety of adjuvant treatment with Yuquan pill soup on top of conventional Western medical treatment,and the effect on renal function.Methods A total of 90 patients with diabetic nephropathy admitted to Nanyang Yuxi Union Hospital in Xixia County,Nanyang City,Henan Province from May 2019 to May 2020 were selected and divided into control group(green ball,N=45)and observation group(red ball,N=45)by red and green ball method.The renal function,efficacy and incidence of adverse reactions were compared between the observation group(combined regimen)and the control group(single western medicine).Results After treatment,the scores of fatigue,less qi and lazy speech,self-sweating and fear of wind,dull complexion,waist and spine pain,sticky mouth,five upset fever,dry mouth and dry throat in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of urinary microalbumin(mAlb),urinary albumin excretion rate(UAER),glycosylated hemoglobin(HbAlc),nitric oxide(NO),endothelin(ET),tumor necrosis factor(TNF-α)and interleukin-1(IL-1)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The safety of the observation group was lower than that of the control group,and the difference was not statistically significant(P>0.05).Conclusion The combined drug regimen in the treatment of diabetic nephropathy has the advantages of“high efficacy,fair safety and obvious improvement of renal function”.