真武汤联合缩泉丸加减对糖尿病肾病Ⅲ期(脾肾阳虚型)患者的临床研究

Clinical study of Zhenwu decoction combined with shrinking spring pill on patients with stageⅢdiabetic ne⁃phropathy(spleen-kidney yang deficiency type)

目的探讨真武汤和缩泉丸加减对糖尿病肾病Ⅲ期(脾肾阳虚型)患者的影响。方法纳入128例糖尿病肾病Ⅲ期(脾肾阳虚型)患者,随机分成观察组和对照组,对照组采用西医常规治疗,观察组联合真武汤和缩泉丸加减治疗,治疗12周后比较两组疗效。结果治疗后,观察组血清转化生长因子-β1(TGF-β1)、糖原合酶激酶-3β(GSK-3β)、白介素-6(IL-6)水平、血清肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白、中医症状总积分低于对照组(t分别=9.84、8.39、11.12、8.83、7.53、8.58、30.76,P均<0.05),而血清血红素加氧酶(HO-1)、氧化物歧化酶(SOD)、白介素-10(IL-10)水平高于对照组(t分别=7.74、19.03、9.58,P均<0.05)。治疗后观察组健康状况调查简表(SF-36)评分高于对照组(t=5.59,P<0.05),总有效率高于对照组(χ^(2)=8.18,P<0.05)。结论对于糖尿病肾病Ⅲ期(脾肾阳虚型)患者而言联合真武汤和缩泉丸加减效果显著,可减轻氧化应激失衡,促进Th1/Th2平衡恢复,促进肾功能恢复,提高临床疗效。

Objective To investigate the effect of Zhenwu Decoction and shrinking spring pill on patients with stageⅢdiabetic nephropathy(spleen-kidney yang deficiency type).Methods All 128 patients with stageⅢdiabetic ne⁃phropathy(spleen-kidney yang deficiency type)were randomly divided into two groups,64 cases in each group.The con⁃trol group was treated with conventional western medicine,while the observation group was treated with Zhenwu decoc⁃tion and shrinking spring pill.The efficacy was compared after 12 weeks of treatment.Results After treatment,the levels of serum transforming growth factor-β1(TGF-β1),glycogen synthase kinase-3β(GSK-3β),interleukin-6(IL-6),the serum creatinine(Scr),urea nitrogen(BUN)and 24h urinary protein in observation group were lower than those in con⁃trol group(t=9.84,8.39,11.12,8.83,7.53,8.58,P<0.05).The serum levels of heme oxygenase(HO-1),oxide dis⁃mutase(SOD)and interleukin-10(IL-10)in observation group were higher than those in control group(t=7.74,19.03,9.58,P<0.05).After treatment,the SF-36 of the observation group was higher than that of the control group(t=5.59,P<0.05).The total effective rate of the observation group was 93.75%(60/64),which was higher than 76.56%(49/64)of the control group(χ^(2)=8.18,P<0.05).Conclusion For patients with stageⅢdiabetic nephropathy(spleen-kidney yang deficiency type),the combination of Zhenwu decoction and shrinking spring pill has a significant effect,which can re⁃duce the imbalance of oxidative stress,promote the recovery of Th1/Th2 balance,promote the recovery of renal function,and improve the clinical efficacy.