当归补血汤对糖尿病肾病气虚血瘀证疗效及肾脏纤维化的影响

The Influence of Chinese Angelica Blood-Supplementing Decoction on Diabetes Nephropathy with Qi Deficiency and Blood Stasis Syndrome and Renal Fibrosis

目的:观察当归补血汤治疗糖尿病肾病气虚血瘀证的临床疗效及其对肾脏纤维化的影响。方法:选择2019年1月至2021年6月在井冈山大学附属医院治疗的糖尿病肾病患者60例,采用随机数字表法分为对照组和治疗组,每组各30例。两组患者均给予基础治疗,对照组在基础治疗基础上加用厄贝沙坦口服,治疗组在基础治疗基础上采用当归补血汤治疗。两组均以2个月为1个疗程,连续治疗3个疗程。比较两组患者血清肾纤维化指标、肾功能、血糖、血脂、24小时尿蛋白定量等指标变化情况。结果:对照组有效率为83.33%,治疗组有效率为93.33%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后,治疗组24小时尿蛋白定量及血尿素氮水平较治疗前明显降低,差异有统计学意义(P<0.05),且组间比较,差异有统计学意义(P<0.05)。两组患者治疗后,空腹血糖(fasting blood Glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平均较治疗前降低,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05),治疗组总胆固醇(total cholesterol,TC)、三酰甘油(triacylglyceride,TG)较治疗前明显降低,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。治疗组治疗后Ⅳ型胶原(collagenⅣ,Col-Ⅳ)、层粘连蛋白(laminin,LN)水平较治疗前明显降低,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。结论:当归补血汤可减轻糖尿病肾病肾脏纤维化的程度,减少尿蛋白,改善肾脏功能。

Objective:To observe the clinical efficacy of Chinese Angelica Blood-Supplementing Decoction on diabetes nephropathy(DN) with qi deficiency and blood stasis syndrome and its influence on renal fibrosis.Methods:A total of 60 patients with DN who were treated in the Affiliated Hospital of Jinggangshan University from January 2019 to June 2021 were selected and divided into the control group and the treatment group according to random number table method,with 30 cases in each group.Both groups were given basic treatment.The control group was additionally given Irbesartan orally on the basis of basic treatment,and the treatment group was additionally given Chinese Angelica Blood-Supplementing Decoction on the basis of basic treatment.Two groups were treated for 2 months as a course of treatment,and both received three consecutive courses of treatment.The changes of serum renal fibrosis index,renal function,blood glucose,blood lipid and 24-hour urine protein were compared between the two groups.Results:The effective rate was 83.33% in the control group and 93.33% in the treatment group.The difference between the two groups was statistically significant(P<0.05).After treatment,the 24-hour urine protein quantity and blood urea nitrogen level in the treatment group were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The differences between the two groups were also statistically significant(P<0.05).After treatment,the levels of FBG and HbA1 c in the two groups were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The differences between the two groups were also statistically significant(P<0.05).TC and TG in the treatment group were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The differences between the two groups were also statistically significant(P<0.05).The levels of Col-Ⅳ and LN in the treatment group after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The differences between the two groups were also statistically significant(P<0.05).Conclusion:Chinese Angelica Blood-Supplementing Decoction can reduce the degree of renal fibrosis in DN,reduce urinary protein excretion and improve renal function.