益气养阴活血方治疗G3A2期糖尿病肾病临床观察

Clinical Observation on the Curative Effect of Yiqi Yangyin Huoxue Recipe on Patients with G3A2Diabetic Nephropathy

目的:观察和评估益气养阴活血方对G3A2期糖尿病肾病患者的疗效。方法:选择2021年9月-2022年3月在我院就诊收治的108例G3A2期糖尿病肾病患者,随机分为两组,每组54例。试验组在控糖、降压、降脂、降低尿蛋白的标准化治疗基础上联合益气养阴活血方治疗;对照组在标准化治疗的同时给予中药安慰剂治疗,共计治疗12周。以治疗前后血清肌酐值(SCr),24小时尿白蛋白排泄率(24h UAER)及空腹血糖值的变化值为主要结局指标,糖化血红蛋白,总胆固醇,尿蛋白转阴率为次要结局指标。结果:两组患者治疗前后的血清肌酐及24小时尿蛋白排泄率变化值差异无统计学意义,空腹血糖值治疗前后差异有统计学意义(P<0.05),提示试验组降糖效果优于对照组。治疗前后糖化血红蛋白与总胆固醇差异两组比较,差异有统计学意义(P<0.05);尿蛋白转阴率试验组数值上呈优趋势,但两组比较,尚未呈现统计学差异(P>0.05)。结论:益气养阴活血法联合标准化治疗,可提高G3A2期糖尿病肾病患者的降糖、降脂效果,但尚未发现联合治疗在改善肾功能,降低尿蛋白方面更有优势。

Objective:To observe and evaluate the efficacy of Yiqi Yangyin Huoxue Recipe on patients with G3A2diabetic nephropathy.Methods:A total of 108patients with G3A2diabetic nephropathy who were treated in our hospital from September 2021to March 2022were randomly divided into two groups,with 54cases in each group.The experimental group was treated with Yiqi Yangyin Huoxue Recipe on the basis of the standardized treatment of controlling blood glucose,blood pressure,lipid and urinary protein;the control group was treated with traditional Chinese medicine placebo for a total of 12weeks of treatment.The changes in serum creatinine(SCr),fasting blood glucose and urinary albumin excretion rate before and after treatment were taken as the primary outcome indicators,and glycosylated hemoglobin,total cholesterol,urine protein negative rate and cystatin C were taken as the secondary outcome indicators.Results:There was no significant difference in serum creatinine and 24h UAER changes before and after treatment between the two groups,but there was a statistically significant difference in fasting blood glucose values before and after treatment(p=0.001),suggesting that the hypoglycemic effect of the experimental group was better than that of the control group.Besides,the differences in glycosylated hemoglobin and total cholesterol between the two groups were statistically significant(P<0.05).The negative conversion rate of urinary protein in the experimental group showed an excellent trend,but there was no statistical difference between the two groups(p=0.054).Conclusion:The combination of Yiqi Yangyin Huoxue Recipe combined with standardized treatment can improve the hypoglycemic and lipid-lowering effect of G3A2diabetic nephropathy patients,but it has not been found that the combined treatment has more advantages in improving renal function and reducing urinary protein.