益气养阴活血方联合中药熏洗治疗糖尿病肾病

Clinical study on the treatment of diabetes nephropathy with Yiqi Yangyin Huoxue Recipe combined with traditional Chinese medicine fumigation and washing therapy

目的探讨益气养阴活血方联合中药熏洗治疗糖尿病肾病临床疗效。方法选择60例糖尿病肾病患者,随机分成对照组和观察组,各30例。对照组予常规西药治疗,观察组在对照组治疗基础上联合益气养阴活血方内服与中药熏洗治疗8周。比较2组空腹血糖(FPG)、餐后2h血糖(2hPG)、日内血糖波动幅度血糖标准差(SDBG)、餐后血糖波动幅度(PPGE)、最大血糖波动幅度(LAGE)、肾功能指标尿素氮(BUN)、血肌酐(Scr)、肾小球滤过率(eGFR)、24h尿蛋白定量(24h Upro)水平,治疗8周后临床疗效以及不良反应发生情况。结果2组治疗后FPG、2hPG水平,血清SDBG、PPGE、LAGE水平,BUN、Scr、24h Upro水平均降低(P均<0.05),且观察组均低于对照组(均P<0.05);2组治疗后eGFR水平均升高(均P<0.05),且观察组高于对照组(P<0.05);观察组总有效率(93.3%,28/30)明显高于对照组(70.0%,21/30)(P<0.05);2组低血糖发生率与不良反应发生率比较,差异无统计学意义(P>0.05)。结论益气养阴活血方联合中药熏洗对糖尿病肾病的治疗效果更为明显,能够控制血糖,缩小血糖波动幅度,减少24h尿蛋白定量,改善肾功能。

Objective To explore the clinical efficacy of Yiqi Yangyin Huoxue Recipe combined with traditional Chinese medicine fumigation and washing therapy in the treatment of diabetes nephropathy.Methods 60 patients with diabetes nephropathy were selected and randomly divided into the control group and the observation group,with 30 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with Yiqi Yangyin Huoxue Recipe combined with traditional Chinese medicine fumigation and washing therapy for 8 weeks on the basis of the treatment of the control group.The levels of fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2hPG),within-day blood glucose excursions[standard deviation of blood glucose(SDBG)],postprandial glucose excursion(PPGE),largest amplitude of glycemic excursion(LAGE),and renal function indicators[the levels of blood urea nitrogen(BUN),serum creatinine(Scr),glomerular filtration rate(eGFR),and 24-hour urine protein quantification(24-hour Upro)]in both groups were compared,and the clinical efficacy and incidence of adverse reactions after 8 weeks of treatment were also compared.Results After treatment,the levels of FPG and 2hPG,serum SDBG,PPGE,LAGE,and the levels of BUN,Scr,and 24-hour Upro in both groups were significantly reduced(P<0.05),and the observation group was lower than the control group(P<0.05);After treatment,the eGFR levels in both groups were increased(P<0.05),and the observation group was higher than the control group(P<0.05);The total effective rate of the observation group(93.3%,28/30)was significantly higher than that of the control group(70.0%,21/30)(P<0.05);There was no statistically significant difference in the incidence of hypoglycemia and adverse reactions between the two groups(P>0.05).Conclusion Yiqi Yangyin Huoxue Recipe combined with traditional Chinese medicine fumigation and washing therapy has more obvious therapeutic effect on diabetes nephropathy,which can effectively control the blood sugar level,reduce the amplitude of glycemic excursion,reduce 24h Upro,and improve renal function.