温阳降浊通络法治疗寒湿瘀滞型糖尿病肾病的临床效果

Clinical efficacy of warming yang,lowering turbidity and dredging collateral therapy on treating diabetic kidney disease with cold-dampness stasis-stagnancy type

目的 观察温阳降浊通络法治疗寒湿瘀滞型糖尿病肾病(DKD)的临床效果。方法 选取2019年7月—2022年12月江西中医药大学附属医院收治的寒湿瘀滞型DKD患者50例,采用随机数字表法分为观察组和对照组,各25例。在一般性治疗基础上,对照组加用厄贝沙坦片治疗,观察组在对照组基础上加温阳降浊通络方剂治疗,2组均连续治疗30 d。比较2组治疗效果,治疗前后中医证候积分、炎性指标[C反应蛋白(CRP)]水平、肾功能指标[尿微量白蛋白(MALB)、尿素氮(BUN)、血肌酐(SCr)]水平、血液流变学指标[纤维蛋白原(Fib)、蛋白酶激活受体(PAR)、血浆黏度(PV)]水平变化等。结果 观察组患者治疗总有效率为76.00%,高于对照组的44.00%(χ^(2)=5.763,P=0.031);治疗后,2组中医证候积分、CRP、MALB、BUN、SCr、Fib、PAR、PV水平均较治疗前降低,观察组均低于对照组(P<0.05或P<0.01)。结论 温阳降浊通络法治疗寒湿瘀滞型DKD的临床效果肯定,可进一步改善临床症状,降低炎性反应程度,改善肾功能,纠正微循环障碍。

Objective To observe the clinical efficacy of warming yang,lowering turbidity and dredging collateral therapy in treating cold-dampness stasis-stagnancy type diabetic kidney disease(DKD).Methods Fifty cases of cold-dampness stasis-stagnancy type DKD patients admitted to the Affiliated Hospital of Jiangxi University of Chinese Medicine from July 2019 to December 2022 were selected.They were randomly divided into an observation group and a control group,with 25 cases in each group.On the basis of conventional treatment,the control group received treatment with Irbesartan tablets,while the observation group received the prescription of warming yang,lowering turbidity and dredging collateral therapy in addition to the control group.Both groups received continuous treatment for 30 days.The treatment effects were compared between the two groups,assessing the changes in TCM syndrome scores,inflammatory factors(CRP),renal function indicators(MALB,BUN,SCr),and hemorheology indicators(Fib,PAR,PV) levels before and after treatment.Results The total effective rate of treatment in the observation group was 76.00%,which was higher than the control group′s 44.00%(χ^(2)=5.763,P=0.031).After treatment,both groups showed a decrease in TCM syndrome scores,CRP,MALB,BUN,SCr,Fib,PAR,and PV levels compared to before treatment,and the observation group had lower levels than the control group for all other indicators(P<0.05 or P<0.01).Conclusion The clinical efficacy of warming yang,lowering turbidity and dredging collateral therapy in treating cold-dampness stasis-stagnancy type DKD is worthy of recognition.It can further improve patients′ clinical symptoms,reduce the degree of inflammatory response,improve renal function,and correct microcirculation disorders.