期刊文献+

消白衍生方治疗糖尿病肾病Ⅲ-Ⅳ期患者尿蛋白的疗效观察 被引量:1

Clinical Efficacy of Xiaobai Yansheng Formula on Proteinuria in Patients withⅢ-ⅣDKD
下载PDF
导出
摘要 目的观察消白衍生方对糖尿病肾病(Diabetic kidneydisease,DKD)Ⅲ-Ⅳ期脾肾阳虚、湿热瘀阻型患者尿蛋白和肾功能的影响。方法选取2020年7月—2021年3月期间上海中医药大学附属曙光医院肾病科门诊及住院收治的DKD(Ⅲ-Ⅳ期)患者63例,按随机数字表分为治疗组33例和对照组30例。对照组予西医常规治疗加载黄葵胶囊,治疗组予西医常规治疗加载消白衍生方。治疗3个月后,观察比较两组患者临床疗效,治疗前后中医症状积分、试验室指标[血肌酐(Serum creatinine,Scr)、尿素氮(Blood Urea Nitrogen,Bun)、估算肾小球滤过率(Estimated Glomerular Filtration Rate,eGFR)、血尿酸(Uricacid,UA)、24 h尿蛋白定量(24-hour urinary protein quantity,24 h UP)、尿白蛋白肌酐比值(Urinary Albumin creatinine ratio,MA/Cr)、尿白蛋白(Urine Albumin,Ualb)、尿转铁蛋白(Urinary Transferrin,UTRF)、尿免疫球蛋白G(Urinary Immunoglobulin G,UIgG)、尿β_(2)微球蛋白(Urineβ_(2)microglobulin,Uβ_(2)-MG)、尿α1微球蛋白(Urineα1 microglobulin,Uα1-MG)、尿液N-乙酰-β-D-氨基葡萄糖苷(Urine N-acetyl-β-D-amino Glucoside,UNAG)、尿视黄醇结合蛋白(Urine Retinol-Binding Protein,URBP)]指标变化。结果治疗后治疗组总有效率81.82%(27/33)高于对照组63.33%(19/30),差异有统计学意义(P<0.01)。治疗后两组患者主、次症、总证候积分较治疗前降低,差异有统计学意义(P<0.05);且治疗组主、次症、总证候积分均低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组Bun、Scr、UA指标较治疗前下降,差异有统计学意义(P<0.05,P<0.01);且治疗组Scr、UA、Bun指标均较对照组明显降低,差异有统计学意义(P<0.01)。治疗后治疗组MA/Cr、UTRF、UIgG、UNAG、24 h UP指标均较治疗前降低,差异有统计学意义(P<0.05,P<0.01);且治疗组UTRF、UIgG、UNAG、MA/Cr、24 h UP指标均较对照组降低,差异有统计学意义(P<0.05,P<0.01)。结论现代常规治疗的基础上加载消白衍生方可以降低糖尿病肾病(Ⅲ-Ⅳ期)脾肾阳虚、湿热瘀型轻、中度蛋白尿患者血肌酐、血尿素氮、血尿酸及24 h UP、MA/Cr,UTRF、UIgG、UNAG的水平,改善中医症状及证候疗效,延缓疾病发展的进程,提高患者的生活质量。 Objective To observe the effects of Xiaobai Yansheng Formula on proteinuria and kidney function in patients withⅢ-Ⅳdiabetic kidney disease(DKD)of spleen-kidney yang deficiency and blockage of dampness-heat syndromes.Methods A total of 63 outpatients and inpatients withⅢ-ⅣDKD treated at the Nephrology Department of Shuguang Hospital,Shanghai University of Traditional Chinese Medicine between July 2020 and March 2021 were randomly divided into a treatment group(n=33)and a control group(n=30)using a random number table.The control group received conventional western treatment along with Huangkui Capsules,while the treatment group received the same western treatment along with Xiaobai Yansheng Formula.After 3 months of treatment,the clinical efficacy,traditional Chinese medicine(TCM)symptom scores,and laboratory indicators[serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),uric acid(UA),24-hour urinary protein quantity(24 h UP),urinary albumin-to-creatinine ratio(MA/Cr),urine albumin(Ualb),urinary transferrin(UTRF),urinary immunoglobulin G(UIgG),urineβ2-microglobulin(Uβ2-MG),urineα1-microglobulin(Uα1-MG),urine N-acetyl-β-D-amino glucoside(UNAG),and urinary retinol-binding protein(URBP)]before and after treatment were compared between the two groups.Results:After treatment,the total effective rate in the treatment group(81.82%,27/33)was significantly higher than the control group(63.33%,19/30)(P<0.01).After treatment,the primary,secondary,and total TCM symptom scores in both groups decreased,and the treatment group was lower than the control group(P<0.05).After treatment,the BUN,Scr,and UA levels in the treatment group decreased(P<0.05,P<0.01),and the treatment group was lower than the control group(P<0.01).The MA/Cr,UTRF,UIgG,UNAG,and 24 h UP levels in the treatment group also decreased after treatment(P<0.05,P<0.01),and the UTRF,UIgG,UNAG,MA/Cr,and 24 h UP in the treatment group were lower than those in the control group(P<0.05,P<0.01).Conclusion Xiaobai Yansheng Formula combined with conventional western medicine in the treatment of proteinuria patients withⅢ-ⅣDKD of spleen-kidney yang deficiency and blockage of dampness-heat syndromes can lower the levels of Scr,BUN,UA,24 h UP,MA/Cr,UTRF,UIgG,and UNAG,improve TCM symptom and syndrome efficacy,delay disease progression,and enhance the patients'quality of life.
作者 虞天璇 王琛 YU Tian-xuan;WANG Chen(Nephropathy Department,Shuguang Hospital,Institute of Traditional Chinese Nephropathy,Shanghai Key Clinical Laboratory of Traditional Chinese Medicine,Key Laboratory of Liver and Kidney Disease Syndromes Ministry of Education,Shanghai University of Traditional Chinese Medicine,Shanghai 201203)
出处 《世界中西医结合杂志》 2023年第7期1396-1400,共5页 World Journal of Integrated Traditional and Western Medicine
基金 国家自然科学基金项目(81973770) 上海市进一步加快中医药事业发展三年行动计划(ZY-(2018-2020)-FWTX-7005)。
关键词 消白衍生方 糖尿病肾病 蛋白尿 临床疗效 Xiaobai Yansheng Formula Diabetic Kidney Disease Proteinuria Clinical Efficacy
  • 相关文献

参考文献6

二级参考文献45

共引文献1510

同被引文献22

引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部