大黄附子细辛汤对早期糖尿病肾病微炎症状态和肾功能的影响

Effect of Dahuang Fuzi Xixin Decoction on microinflammatory state and renal function in early diabetic nephropathy

目的:探讨大黄附子细辛汤灌肠治疗对早期糖尿病肾病(early diabetic nephropathy,EDN)脾肾阳虚证患者微炎症状态和肾功能的影响。方法:选取福建省第三人民医院内分泌科2021年9月—2022年9月收治的68例EDN脾肾阳虚证患者,按随机数字表法分为对照组与研究组,每组各34例。对照组采用西医常规治疗,研究组在对照组基础上加用大黄附子细辛汤灌肠治疗,比较两组患者治疗前后中医证候积分(畏寒肢冷、纳差反胃、浮肿、腰腿酸软、大便溏稀、面色白)及血清肌酐(SCr)、肿瘤坏死因子-α(TNF-α)、血尿素氮(BUN)、白介素-6(IL-6)、胱抑素C(Cys C)、C反应蛋白(CRP)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、三酰甘油(TG)含量的变化。结果:治疗后研究组患者血清HDL-C水平高于对照组,其他检测指标均低于对照组,各项中医证候积分低于对照组,差异均有统计学意义(P<0.01)。结论:大黄附子细辛汤灌肠治疗可有效改善EDN脾肾阳虚证患者微炎症状态,纠正机体脂质代谢紊乱,促进肾代谢,改善肾功能,临床疗效确切。

Objective:To investigate the effect of Dahuang Fuzi Xixin Decoction enema on microinflammatory state and renal function in patients with early diabetic nephropathy(EDN)with Yang deficiency of spleen and kidney syndrome.Methods:A total of 68 EDN patients with Yang deficiency of spleen and kidney syndrome admitted to the Department of Endocrinology of the third people′s hospital of fujian province from September 2021 to September 2022 were selected and divided into the control group and the study group according to the random number table method,with 34 cases in each group.The patients in the control group were treated with conventional western medicine,and the patients in the study group were treated with Dahuang Fuzi Xixin Decoction enema on the treatment basis of the control group.The TCM syndrome scores(intolerance of cold and cold limbs,poor appetite and nausea,edema,lassitude in waist and legs,loose stool,pale complexion),serum creatinine(SCr),tumor necrosis factor-α(TNF-α),blood urea nitrogen(BUN),interleukin-6(IL-6)and cystatin C(Cys),C-reactive protein(CRP),low density lipoprotein(LDL-C),total cholesterol(TC),high density lipoprotein(HDL-C)and triglyceride(TG)were compared between the two groups before and after treatment.Results:After treatment,the serum HDL-C level of the study group was higher than that of the control group,the other detection indexes were lower than that of the control group,and the scores of TCM syndrome were lower than that of the control group.The differences were statistically significant(P<0.01).Conclusion:Dahuang Fuzi Xixin Decoction enema can effectively improve the microinflammatory state of EDN patients with Yang deficiency of spleen and kidney syndrome,correct the body lipid metabolism disorder,promote renal metabolism,and improve renal function.It has a definite clinical effect.