当归六黄汤加味联合厄贝沙坦治疗气阴两虚证2型糖尿病肾病临床研究

Clinical Study on Modified Danggui Liuhuang Decoction Combined with Irbesartan for Type 2 Diabetic Nephropathy with Qi-Yin Deficiency Syndrome

目的:观察当归六黄汤加味联合厄贝沙坦治疗气阴两虚证2型糖尿病肾病(DN)的临床疗效。方法:筛选2型DN(Ⅲ期)患者126例,随机分为对照组和治疗组各63例。2组均予控制血脂、血糖等常规治疗,对照组加用厄贝沙坦片口服,治疗组在对照组的基础上加用当归六黄汤加味治疗。连续治疗12周后,比较2组肾功能指标[24 h尿蛋白、血尿素氮(BUN)、血肌酐(SCr)]、气阴两虚证证候评分及临床疗效。结果:治疗组总有效率为88.89%,对照组为73.02%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组24 h尿蛋白、BUN、SCr水平比较,差异无统计学意义(P>0.05);治疗后,2组24 h尿蛋白、BUN、SCr水平均较治疗前明显下降(P<0.05),且治疗组3项肾功能指标均低于较对照组(P<0.05)。治疗前,2组倦怠乏力、心悸气短、头晕耳鸣、自汗、盗汗等中医证候评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项证候评分均较治疗前明显下降(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。结论:当归六黄汤加味联合厄贝沙坦治疗气阴两虚证2型DN,能进一步改善患者肾功能和中医证候,提高临床疗效。

Objective:To observe the clinical effect of modified Danggui Liuhuang Decoction combined with Irbesartan for type 2 diabetic nephropathy(DN)with qi-yin deficiency syndrome.Methods:A total of126 cases of patients with type 2 DN(stage Ⅲ)were screened and randomly divided into the control group and the treatment group,with 63 cases in each group.Both groups were treated with conventional treatments such as controlling blood lipids and blood glucose;the control group was additionally treated with oral administration with Irbesartan Tablets;the treatment group was additionally treated with modified Danggui Liuhuang Decoction based on the treatment of the control group.After 12 weeks of continuous treatment,the levels of kidney function indexes[24-hour urine protein,blood urea nitrogen(BUN),and serum creatinine(SCr)],the scores of qi-yin deficiency syndrome,and clinical effects were compared between the two groups.Results:The total effective rate was 88.89% in the treatment group,and 73.02% in the control group,the difference being significant when comparing between the two groups(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of 24-hour urine protein,BUN,and SCr between the two groups(P>0.05).After treatment,levels of 24-hour urine protein,BUN,and SCr in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the three kidney function indexes in the treatment group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of traditional Chinese medicine(TCM)syndrome scores of fatigue and lack of strength,palpitations and shortness of breath,dizziness,spontaneous sweating,and night sweat between the two groups(P>0.05);after treatment,the above TCM syndrome scores in the two groups were significantly decreased when compared with those before treatment(P<0.05),and each score in the treatment group was lower than that in the control group(P<0.05).Conclusion:Modified Danggui Liuhuang Decoction combined with Irbesartan for type 2 DN with qi-yin deficiency syndrome can further improve kidney function,TCM syndromes,and clinical effects.