益肾健脾汤加味辅助治疗脾肾阳虚型糖尿病肾病临床研究

Clinical Study on Modified Yishen Jianpi Decoction in Adjuvant Therapy of Diabetic Kidney Disease of Spleen-Kidney Yang Deficiency Type

目的:观察益肾健脾汤加味辅助治疗脾肾阳虚型糖尿病肾病的临床疗效。方法:采用随机数字表法将102例脾肾阳虚型糖尿病肾病患者分为对照组、治疗组各51例。对照组采用常规西医治疗,治疗组在对照组的基础上增加益肾健脾汤加味治疗。比较2组治疗前后中医证候积分、肾功能指标、血糖指标和炎症因子,并评估2组临床疗效和用药安全性。结果:治疗组总有效率高于对照组(P<0.05)。2组治疗后中医证候积分、24 h尿蛋白定量(24 h-UP)、血肌酐(SCr)、血尿素氮(BUN)均较治疗前降低(P<0.05),治疗组治疗后中医证候积分、肾功能指标均低于对照组(P<0.05)。2组治疗后空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbAlc)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)均低于治疗前(P<0.05),且治疗组治疗后上述血糖指标和炎症因子均低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:益肾健脾汤加味辅助治疗脾肾阳虚型糖尿病肾病,能改善患者肾功能,减轻炎症反应,降低血糖,疗效显著,安全性较高。

Objective:To observe the clinical effect of modified Yishen Jianpi Decoction in adjuvant therapy of diabetic kidney disease of spleen-kidney yang deficiency type.Methods:A total of 102 cases of patients with diabetic kidney disease of spleen-kidney yang deficiency type were divided into the control group and the treatment group according to the random number table method,with 51 cases in each group.The control group was treated with conventional western medicine,and the treatment group based on the treatment of the control group was additionally treated with modified Yishen Jianpi Decoction.Traditional Chinese medicine(TCM)syndrome scores,the kidney function indexes,blood glucose indexes and inflammatory factors were compared between the two groups before and after treatment.Clinical effects and medication safety were evaluated in the two groups.Results:The total effective rate of the treatment group was higher than that of the control group(P<0.05).The TCM syndrome scores,24-hour urine protein quantification(24 h-UP),serum creatinine(SCr),and blood urea nitrogen(BUN)in the two groups after treatment were decreased when compared with those before treatment(P<0.05),and the TCM syndrome scores and kidney function indexes in the treatment group after treatment were lower than those in the control group(P<0.05).The fasting blood glucose(FBG),2-hour postprandial blood glucose(P2hBG),glycosylated hemoglobin(HbAlc),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups after treatment were decreased when compared with those before treatment(P<0.05),and the above blood glucose indexes and inflammatory factors in the treatment group after treatment were lower than those in the control group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Yishen Jianpi Decoction in adjuvant therapy of diabetic kidney disease of spleen-kidney yang deficiency type can effectively improve the kidney function,alleviate inflammatory responses and lower blood sugar,with a significant curative effect and high safety.