保肾健脾活血汤联合缬沙坦对糖尿病肾病患者高凝状态和微炎症状态的影响

Effect of Baoshen Jianpi Huoxue Decoction Combined with Valsartan on Hypercoagulable State and Microinflammatory State for Patients with Diabetic Nephropathy

目的:观察保肾健脾活血汤联合缬沙坦对糖尿病肾病患者高凝状态和微炎症状态的影响。方法:将90例糖尿病肾病患者随机分为观察组(n=45例)和对照组(n=45例)。2组均接受常规西医基础治疗,对照组给予缬沙坦胶囊治疗,观察组在对照组基础上加用保肾健脾活血汤治疗,疗程为8周。统计2组临床疗效,比较2组治疗前后血糖指标,肾功能指标、D-二聚体、纤维蛋白原、IL-6、TNF-α水平。结果:观察组治疗总有效率为,对照组为,观察组显著高于对照组(P<0.05);两组治疗后中医证候积分显著降低(P<0.05),治疗后观察组中医证候积分低于对照组(P<0.05)。两组治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、血肌酐、血尿素氮、尿β2-MG、UAER均较治疗前降低,观察组治疗后上述指标低于对照组。两组治疗后血浆D-二聚体、纤维蛋白原、IL-6、TNF-α明显降低(P<0.05),观察组治疗的上述指标均低于对照组(P<0.05)。结论:保肾健脾活血汤联合缬沙坦治疗糖尿病肾病的疗效确定,不仅可改善症状,还能缓解机体高凝状态与微炎症状态,有利于肾功能的改善。

Objective:To observe the effect of Baoshen Jianpi Huoxue Decoction combined with valsartan on hypercoagulability and microinflammation for patients with diabetic nephropathy.Methods:90 patients with diabetic nephropathy were randomly divided into an observation group(n=45)and a controlled group(n=45).The controlled group was treated with Valsartan Capsule,and the observation group was treated with Baoshen Jianpi Huoxue Decoction on the basis of the controlled group.The course of treatment was 8 weeks.The clinical effects of the two groups were statistically analyzed,and the indexes of blood glucose,renal function,D-dimer,fibrinogen,IL-6 and TNF-αlevels before and after treatment were compared.Results:The total effective rate of the observation group was significantly higher than the controledl group(P<0.05).After treatment,the TCM symptom score of the two groups decreased significantly(P<0.05),and the TCM symptom score of the study group was lower than that of the controlled group(P<0.05).FPG,2hPG,HOMA-IR,HbA1c,SCR,bun and urine in two groups after treatmentβ2-mg and UAER were lower than before treatment,and the above indexes in the observation group were lower than those in the controlled group after treatment.After treatment,plasma D-dimer,fibrinogen,IL-6 and TNF-αlevels in the two groups were significantly higher than those in the controlled group.The above indexes in the observation group were lower than those in the controlled group(P<0.05).Conclusion:The curative effect of Baoshen Jianpi Huoxue Decoction combined with Valsartan in the treatment of diabetic nephropathy is confirmed,which can not only improve the symptoms,but also relieve the hypercoagulable state and micro inflammatory state of the body,which is conducive to the improvement of renal function.