加味参芪地黄汤联合氯沙坦钾片治疗糖尿病肾病的临床疗效观察

Clinical Observation of Jiawei Shenqi Dihuang Decoction Combined with Losartan Potassium Tablets in the Treatment of Diabetic Nephropathy

目的探讨加味参芪地黄汤联合氯沙坦钾片治疗糖尿病肾病(diabetic kidney disease,DKD)的临床疗效。方法收集2020年7月—2021年7月三明市沙县区凤岗街道城区社区卫生服务中心收治的DKD患者60例,随机分为对照组和研究组各30例。对照组接受氯沙坦钾片治疗,研究组接受氯沙坦钾片联合加味参芪地黄汤治疗,两组均治疗3个月。比较两组的临床疗效、中医证候评分、血糖水平[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 hPG)、糖化血红蛋白(glycated hemoglobin,HbAlc)]、尿蛋白水平[24 h尿蛋白定量(24 h urinary protein quantification,24 h UAE)、尿β2微球蛋白(urinaryβ2microglobulin,β2-MG)、尿微量白蛋白(urinary microalbumin,mAlb)、尿蛋白与肌酐的比值(urinary protein to creatinine ratio,ACR)]。结果治疗后,研究组的主证及次证中医证候评分低于对照组,差异有统计学意义(P<0.05);研究组FBG、2 hPG、HbAlc、24hUAE、β2-MG、mAlb、ACR水平低于对照组,差异有统计学意义(P<0.05)。结论应用加味参芪地黄汤联合氯沙坦钾片治疗DKD,可获得较好的临床效果,能够有效缓解患者的临床症状,改善血糖及尿蛋白水平。

Objective To explore the clinical efficacy of Jiawei Shenqi Dihuang Decoction combined with losartan potassium tablets in the treatment of diabetic kidney disease(DKD).Methods Atotal of 60 cases of DKD patients admitted to Community Health Service Center of Fenggang Street Urban Area in Shaxian District of Sanming from July 2020 to July 2021 were collected and randomly divide into control group and research group with 30 cases in each group.The control group was treated with losartan potassium tablets,the research group was treated with losartan potassium tablets combined with Jiawei Shenqi Dihuang Decoction,and both groups were treated for 3 months.The clinical efficacy,syndrome scores of traditional Chinese medicine,blood glucose level[fasting blood glucose(FBG),2 h postprandial glucose(2 hPG),glycosylated hemoglobin HbAlc],urinary protein level[24 h urinary protein quantification(24 hUAE),Urinaryβ2 microglobulin(β2-MG),urinary microalbumin(mAlb),urinary protein-creatinine ratio(ACR)were compared between the two groups].Results After treatment,the primary and secondary syndrome scores of traditional Chinese medicine in the research group were significantly lower than those in the control group(P<0.05).The levels of FBG,2 hPG,HbAlc,24 hUAE,β2-MG,mAlb,and ACR in the research group were signifcantly lower those in the control group(P<0.05).Conclusion The application of modified Jiawei Shenqi Dihuang Decoction combined with losartan potassium tablets in the treatment of patients with DKD could achieve better clinical results,effectively alleviate the clinical symptoms of patients,and improve the level of blood glucoseand urinaryprotein.