消渴益肾汤加减治疗早期2型糖尿病肾病蛋白尿患者的效果观察

Observation on the effect of modified Xiaoke Yishen decoction on patients with early type 2 diabetic kidney disease and proteinuria

目的观察消渴益肾汤加减治疗早期2型糖尿病肾病(T2DKD)蛋白尿患者的效果。方法160例早期T2DKD蛋白尿患者,随机分为观察组和对照组,各80例。对照组患者给予西药常规对症治疗,观察组患者在对照组的治疗基础上给予消渴益肾汤加减治疗。比较两组治疗后临床治疗效果,尿微量白蛋白与尿肌酐比值(UACR)和肾小球滤过率(eGFR)水平,血压、血脂及血糖水平。结果治疗后,观察组的治疗总有效率85.00%较对照组的71.25%明显更高(P<0.05)。治疗后,观察组UACR(47.0±17.5)mg/g明显低于对照组的(68.0±14.5)mg/g(P<0.05);但两组的eGFR水平无明显差别(P>0.05)。治疗后,观察组的空腹血糖(FBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)分别为(6.3±1.6)mmol/L、(7.6±1.4)%、(3.3±1.3)mmol/L、(2.1±0.7)mmol/L、(116.4±10.9)mm Hg(1 mm Hg=0.133 kPa)、(74.9±11.7)mm Hg,均低于对照组的(7.4±2.4)mmol/L、(9.0±2.1)%、(4.7±1.2)mmol/L、(2.7±0.7)mmol/L、(138.2±15.2)mm Hg、(86.6±12.7)mm Hg(P<0.05)。结论通过消渴益肾汤加减治疗早期T2DKD蛋白尿患者,可以显著减轻患者的临床症状,改善患者的肾功能,降低血糖,疗效确切,可以在临床推广使用。

Objective To observe the effect of modified Xiaoke Yishen decoction on patients with early type 2 diabetic kidney disease(T2DKD)and proteinuria.Methods 160 patients with early T2DKD and proteinuria were randomly divided into an observation group and a control group,with 80 patients in each group.The control group was given conventional symptomatic treatment of Western medicine,and the observation group was given modified Xiaoke Yishen decoction on the basis of the treatment of the control group.The clinical effect,urine microalbumin-to-urinary creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR)levels,blood pressure,blood lipid and blood glucose levels after treatment were compared between the two groups.Results After treatment,the total effective rate was 85.00% in the observation group,which was significantly higher than 71.25% in the control group(P<0.05).After treatment,UACR was(47.0±17.5)mg/g in the observation group,which was significantly lower than(68.0±14.5)mg/g in the control group(P<0.05).There was no significant difference in eGFR levels between the two groups(P>0.05).After treatment,the fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the observation group were(6.3±1.6)mmol/L,(7.6±1.4)%,(3.3±1.3)mmol/L,(2.1±0.7)mmol/L,(116.4±10.9)mm Hg(1 mm Hg=0.133 kPa)and(74.9±11.7)mm Hg,which were lower than(7.4±2.4)mmol/L,(9.0±2.1)%,(4.7±1.2)mmol/L,(2.7±0.7)mmol/L,(138.2±15.2)mm Hg and(86.6±12.7)mm Hg in the control group(P<0.05).Conclusion The modified Xiaoke Yishen decoction shows definite efficacy for patients with early T2DKD and proteinuria,which can obviously relieve the clinical symptoms,improve the renal function and lower the blood sugar of the patients,so it can be used in clinical promotion.