温阳补脾方加减治疗糖尿病肾病脾肾两虚证的效果

Effect of Wenyang Bupi Formula on Deficiency of Spleen and Kidney in Diabetes Nephropathy

目的探讨温阳补脾方加减治疗糖尿病肾病(DN)脾肾两虚证的效果。方法本研究采用前瞻性随机对照分析,纳入2021年6月至2022年6月新密市中医院收治的84例脾肾两虚证DN患者为研究对象,按照随机号码表法分为观察组和对照组,各42例。对照组患者接受西医常规治疗,观察组在此基础上接受温阳补脾方加减治疗,均治疗12周。观察两组临床疗效、肾功能[血清肌酐(Cr)、血尿氮素(BUN)、24 h尿蛋白定量(24 h UTP)及肾小球滤过率(eGFR)]、血糖(空腹血糖、餐后2 h血糖)水平,观察治疗期间不良反应发生情况。结果治疗12周,观察组临床总有效率高于对照组(P<0.05),Cr、BUN、24 h UTP水平低于对照组(P<0.05),eGFR水平高于对照组(P<0.05),空腹血糖、餐后2 h血糖低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论温阳补脾方加减治疗DN脾肾两虚证患者临床效果确切,可改善患者的肾功能,改善血糖血脂代谢,且不会增加药物副作用。

Objective To explore the clinical application effect of modified Wenyang Bupi formula in treating spleen and kidney deficiency syndrome of diabetic nephropathy(DN).Methods This study used a prospective randomized controlled analysis and included 84 DN patients with spleen kidney deficiency syndrome admitted to Xinmi Hospital of Traditional Chinese Medicine from June 2021 to June 2022 as the study subjects.According to the random number table method,they were divided into observation group and control group randomly,with 42 cases in each group.The control group patients received routine Western medicine treatment,while the observation group was treated with modified Wenyang Bupi formula for 12 weeks.The clinical efficacy,renal function[serum creatinine(Cr),blood and urine nitrogen(BUN),24-hour urinary protein quantification(24 h UTP)and estimated glomerular filtration rate(eGFR)],blood glucose(fasting blood glucose,2-hour postprandial blood glucose)levels were observed in the two groups,and the adverse reactions during treatment were observed.Results After 12 weeks of treatment,compared with the control group,the total effective rate of clinical efficacy in the observation group was higher(P<0.05).Compared with the control group,the levels of Cr,BUN,and 24-hour UTP in the observation group were lower,while the level of eGFR was higher(P<0.05).Compared with control group,the fasting blood glucose and 2-hour postprandial blood glucose in the observation group were lower(P<0.05).The difference was not statistically significant in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The modified Wenyang Bupi formula has a significant clinical effect on treating DN patients with spleen kidney deficiency syndrome.It can significantly improve renal function,improve blood glucose metabolism,and will not increase drug side effects.