益肾化浊汤治疗糖尿病肾病肾阴阳两虚证32例临床观察

Yishen Huazhuo Decoction in Treatment of Patients with Diabetic Nephropathy with Kidney Yin-Yang Deficiency:A Clinical Observation of 32 Cases

目的观察益肾化浊汤治疗糖尿病肾病(diabetic nephropathy,DN)肾阴阳两虚证的临床疗效及其对微量白蛋白尿的影响。方法将64例DNⅢ期伴微量白蛋白尿患者随机分为对照组和观察组,每组32例。对照组给予糖尿病降糖药物基础治疗,观察组在对照组治疗基础上加用益肾化浊汤治疗,10 d为1个疗程,共治疗4个疗程。观察和比较两组患者治疗前后肾功能指标[血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr)、尿白蛋白/肌酐比值(urinary albumin/creatinine ratio,UACR)、肾小球滤过率估算值(estimated glomerular filtration,eGFR)]、临床疗效、中医证候积分以及不良反应。结果观察组临床疗效优于对照组(P<0.05)。两组患者治疗后各项中医证候积分均较治疗前显著减少(P<0.05),且观察组减少程度大于对照组(P<0.05)。与治疗前比较,治疗后两组患者BUN、SCr、UACR水平均显著下降(P<0.05),eGFR水平显著升高(P<0.05);观察组BUN、SCr、UACR、eGFR改善程度均优于对照组(P<0.05)。两组治疗过程中未见不良反应。结论益肾化浊汤治疗DN患者疗效显著,可明显改善患者微量白蛋白尿,且安全性高。

Objective To investigate the efficacy of Yishen Huazhuo Decoction in the treatment of patients with diabetic nephropathy(DN)with kidney Yin-Yang deficiency and its effect on microalbuminuria.Methods A total of 64 patients with stageⅢDN and microalbuminuria were enrolled and randomly divided into control group and observation group,with 32 patients in each group.The patients in the control group were given the basic treatment with hypoglycemic drugs for diabetes,and those in the observation group were given Yishen Huazhuo Decoction in addition to the treatment in the control group.Each course of treatment was 10 days,and both groups were treated for 4 courses.The two groups were observed and compared in terms of renal function markers [blood urea nitrogen(BUN), serum creatinine(SCr), urinary albumin/creatinine ratio(UACR), and estimated glomerular filtration(eGFR)] before and after treatment, clinical outcome, traditional Chinese medicine (TCM) symptom score, and adverse reactions.Results The observation group had a significantly better clinical outcome than the control group ( P<0.05 ). After treatment, both groups had significant reductions in TCM symptom scores ( P< 0.05 ), and the observation group had significantly greater reductions than the control group ( P<0.05 ). After treatment, both groups had significant reductions in the levels of BUN,SCr, and UACR ( P<0.05 ) and a significant increase in the level of eGFR ( P<0.05 ), and the observation group had significantly greater improvements in BUN,SCr,UACR, and eGFR than the control group ( P<0.05 ). No adverse reaction was observed during treatment.Conclusion Yishen Huazhuo Decoction has a marked clinical effect in the treatment of patients with DN and can significantly improve microalbuminuria, with a favorable safety profile.