Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

Objective:To establish a rat model of type 2 diabetes(T2DM)manifesting the Chinese medicine syndrome pattern of both qi and yin deficiency for evaluating the efficacy of a Chinese herbal formula(CHF),integrative medicine(IM),and pioglitazone(PIO)on T2DM indicators in the animal model.Methods:The rat model was induced by a high-fat diet(HFD)and streptozotocin(STZ,30 mg/kg).CHF(3.4 g/kg),PIO(2.7 mg/kg),and IM(3.4 g CHF+2.7 mg PIO)were administered to rats once daily for 14 days.Related laboratory parameters were observed.Results:Diabetic rats showed unsmooth fur,alopecia,reduced activity,huddling,somnolence,depression,pale or reddened tongue,damp/dark red tail,and high levels of water and food intake,urine volume,and stool weight,but weakened grip strength.Low levels of serum SOD,Nat-Kt-ATPase,cAMP/cGMP,and a high level of iNOS were observed.Hyperglycemia,hyperinsulinemia,insulin resistance,high levels of serum glucagon/IDE and pancreatic amylin,and low serum and pancreatic SS levels were evident as well.Conclusions:A rat model of T2DM with both qi and yin deficiency was successfully replicated.CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM,though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Yiqi Huoxue Decoction in the treatment of Qi and yin deficiency and stasis type diabetic nephropathy in stageⅢ and its effect on VEGF and TGF-β1

Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β1).Methods:Sixty patients with stage DN of Qi-yin deficiency and stasis type DN who were treated in the Endocrinology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to December 2019 were selected as the research subjects.The remainder method was used to divide them into 30 cases in the observation group and 30 cases in the control group.Patients in both groups were referred to the guidelines and expert consensus for general treatment of DN(hypogl-ycemic,antihypertensive,lipid-lowering,etc.).The control group was given pancreatic kallikrein enteric-coated tablets orally once,120U,3 times a day,and the observation group was given The traditional Chinese medicine Yiqi Huoxue Decoction was taken orally,one dose daily,twice a day in the morning and evening;the two groups intervened continuously for 8 weeks.Detect blood FPG,PBG,HbA1c,β2-MG,BUN,SCr,VEGF,TGF-β1,and urine mALB and UACR levels before and after treatment,and calculate eGFR before and after treatment in both groups;observe changes in TCM syndrome scores in the two groups,Compare its clinical efficacy.Results:After 8 weeks of treatment,the total clinical effective rate of patients in the observation group was 93.3%,which was significantly different from the control group of 76.6%(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those before treatment and in the control group(P<0.05);The levels of FPG,HbA1c,PPG,mALB,β2-MG,UACR,VEGF,and TGF-β1 in the observation group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of SCr and BUN in the observation group were significantly lower.Compared with before treatment,eGFR increased,but there was no signi-ficant difference(P>0.05).Conclusion:Yiqi Huoxue Decoction for the treatment of patients with DN typeⅢqi-yin deficiency and stasis type,not only helps to lower blood sugar levels,improve TCM syndromes,but also can reduce early renal damage,reduce urine albumin,and delay kidney function It may be further worsened and has better safety.The mechanism may be related to reducing the levels of VEGF and TGF-β1,thereby delaying the fibrosis of tubulointerstitial scar and inhibi-ting glomerular capillary sclerosis.

Effect of Huangqi Xiaoke Recipe combined with alprostadil on qi and yin deficiency type diabetic nephropathy and its effect on vascular endothelium and oxidative stress

Objective: To observe the clinical efficacy of Huangqi Xiaoke Decoction combined with alprostadil on qi and yin deficiency type diabetic nephropathy (DN) and its effect on vascular endothelium and oxidative stress. Methods: A total of 72 patients with qi and yin deficiency type DN who were admitted to the diabetes specialist ward and outpatient department of Baoan District Hospital of Shenzhen from January 2017 to July 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number method. 36 cases in each group. Both groups were treated with conventional treatments such as hypoglycemic, hypotensive, lipid-lowering and anti-platelet aggregation. The control group was treated with alprostadil on the basis of conventional treatment. The observation group was given orally on the basis of the control group. Both groups were treated once a day for a total of 4 weeks. Compare the clinical syndrome scores and clinical efficacy of the two groups before and after treatment;fasting blood glucose (FPG), glycosylated hemoglobin (HbA1C), blood lipids (TC, TG, LDL, HDL), serum creatinine (SCr), blood urea nitrogen (BUN Endothelin-1 (ET-1), nitric oxide (NO), von Willebrand factor (vWF);glutathione peroxidase (GSH-Px), superoxide disproportionation The level of enzyme (SOD), malondialdehyde (MDA). Results:The total effective rate of TCM syndromes in observation group was 94.44%, which was significantly different from 72.22% in the control group. The scores of TCM syndromes in the observation group were significantly lower than those in the control group;Compared with the control group, the HDL-C of the observation group did not change much, there was no statistical difference;FBG, HbA1C, SCr, BUN, TC, TG, LDL-C, ET-1, vWF, MDA Significantly decreased, NO, GSH-Px, SOD increased significantly, with significant difference. Conclusion: Huangqi Xiaoke Decoction combined with alprostadil in the treatment of qi and yin deficiency type DN has significant curative effect, which can not only lower blood sugar, regulate blood lipids, improve renal function and clinical symptoms, but also inhibit oxidative stress and protect endothelial function.

Thirty-two cases of type 2 diabetes mellitus of qi and yin deficiency treated with laser acupuncture

Objective To observe the clinical therapeutic effect of laser acupuncture on type 2 diabetes mellitus(T2DM)of qi and yin deficiency type.Methods Laser acupuncture was used to treat 32 patients of T2DM.Acupoint selection:Fèishū(肺俞BL13),Píshū(脾俞BL20),Shènshū(肾俞BL23),Wǎnxiàshū(胃脘下俞EX-B3),Sānyīnjiāo(三阴交SP6)and Zúsānlĭ足三里(ST36).It took 20 min in each treatment,five treatments a week.There were 2 days of interval in 2 weeks of treatment.Before and after treatment,the changes in fasting plasma glucose(FPG),postprandial 2 h glucose(2hPG),fasting insulin(FINS),glycosylated albumin(GA),insulin resistance index(HOMA-IR)and the symptom score of traditional Chinese medicine(TCM)were observed in the patients.The therapeutic effect was evaluated.Results Of 32 cases,8 cases were remarkably effective,18 cases effective and 6 cases failed.The total effective rate was 81.3%.At the end of treatment course,the level of every indicator after treatment was significantly lower than that before treatment(all P<0.01).Conclusion Laser acupuncture achieves the significant therapeutic effect on T2DM of qi and yin deficiency and this therapy deserves to be promoted in clinical application.

The Combined Use of Tonification and Purgation in Treatment of Fatty Liver

Fatty liver is a disease caused by excessive accumulation of fat in the liver due to long-term ort repeated affection of various causative factors'When the pathogenic factor prevails,the qi is sure to be deficient',Therefore,deficiency of the vital-qicontributes greatly to the occurrence of fatty liver.For many years,the author has concentrated ont the treatment of fatty liver with the tonificatioin method,or tonification followed by purgation,or the combination of tonificaytioin with purgation,so as to effectively prevent the liver from being injured by harmful substances ,and to benefit the recovery of fatty liver.The following is a report of his experience in treatment of fatty liver with the combined use of tonification and purgation.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

TCM DIFFERENTIAL TREATMENT OF CHILD HOOD PERSISTING PNEUMONIA -A Report of 52 Cases

According to TCM differentiation of the symptoms and signs, 52 children with presisting pneumonia were divided into the following four types: 1) deficiency of body fluid due to accumulation of heat in the lung, 2) earth failing to generate metal, 3) deficiency of the Ying and Wei systems, and 4) excessiveness of pathogens due to qi deficiency. After treatment for 2-3 weeks, 40 cases were cured, 8 improved, and 4 ineffective.

Effects on type 2 diabetes complicated with pulmonary tuberculosis:regiment of insulin,isoniazid,rifampicin,pyrazinamide and ethambutol versus the regiment plus Qi-boosting and Yin-nourishing decoction of Traditional Chinese Medicine

OBjECTIVE:To observe the clinical effect on type 2diabetes mellitus(T2DM) complicated with pulmonary tuberculosis(TB) of insulin,isoniazid,rifampicin,pyrazinamide and ethambutol(conventional medication) administered together with Qi-boosting and Yin-nourishing decoction derived from Traditional Chinese Medicine(TCM).METHODS:A total of 60 patients with T2 DM complicated with pulmonary TB were randomly and equally divided into positive control group and treatment group.The control group was treated with Western conventional regiment(WCR):insulin,isoniazid,rifampicin,pyrazinamide,and ethambutol,whereas the treatment group was given both WCR and Qi-boosting and V/n-nourishing decoction prepared from TCM.RESULTS:After the treatment,20(66.7%) and 11(36.7%) cases showed sputum bacteria negative conversion in the WCR plus TCM group and WCM group respectively(P < 0.05).A total of 25(83.3%)and 18(60%) cases showed improvement in lung lesion in the WCR plus TCM group and WCM group respectively(P < 0.05).Compared with WCR group,fasting plasma glucose and 2-hour postprandial blood glucose levels in the WCR plus TCM group significantly decreased(P < 0.05 and P < 0.01,respectively).CONCLUSION:Qi-boosting and Yin-nourishing decoction combined with the Western medication showed better curative effect in treating T2 DM complicated with pulmonary TB compared with the group using the conventional Western Medicine alone.

玉女煎联合沙参麦冬汤治疗阴虚火旺型糖尿病的疗效及对患者血清Vaspin、Omentin-1的影响

目的:观察玉女煎联合沙参麦冬汤对阴虚火旺型糖尿病患者的疗效及血清内脏脂肪特异性丝氨酸蛋白酶抑制因子(Visceral Fat Specific Serine Protease Inhibitor,Vaspin)、网膜素-1(Omentin-1)的影响。方法:将我院2018年3月至2019年11月阴虚火旺型糖尿病患者89例,随机分为对照组42例和观察组47例,对照组采用二甲双胍治疗;观察组采用玉女煎联合沙参麦冬汤治疗,以持续治疗8周为1疗程。比较两组间的临床疗效,测定血清糖化血红蛋白(Glycosylated Hemoglobin,HbAlc)、空腹血糖(Fasting Blood Glucose,FBG)、空腹胰岛素(Fasting Insulin,Fins)、胰岛素抵抗指数(Insulin Resistance Index,Homa-IR)和Vaspin、Omentin-1水平。结果:与对照组比,观察组治疗8周血清HbAlc、FBG、Fins及Homa-IR较低,差异有统计学意义(P<0.05)。与对照组比,观察组治疗8周血清vaspin、Omentin-1水平较低,差异有统计学意义(P<0.05)。对照组有效率80.95%低于观察组95.74%,差异有统计学意义(P<0.05)。两组间不良率比较,差异无统计学意义(P>0.05)。结论:玉女煎联合沙参麦冬汤对阴虚火旺型糖尿病患者的疗效确切,可降低血清Vaspin、Omentin-1,改善血糖代谢,且安全性高,值得推广。

Need of integrated dietary therapy for persons with diabetes mellitus and “unhealthy” body constitution presentations

From a perspective of Chinese medicine （CM）, persons with unregulated ＂unhealthy＂ body constitution （BC） will further develop chronic diseases, such as diabetes mellitus （DM）. Conventional dietary therapy with nutrition component has its limitations in the regulation of ＂unhealthy＂ BC. However, empirical evidence supports that ＂unhealthy＂ BC can be regulated with food natures and flavors from a perspective of CM. Presentations of ＂unhealthy＂ BC types, such as Yin-deficiency, Yang-deficiency and Yin-Yangdeficiency were found in persons with DM. It would be necessary to regulate the ＂unhealthy＂ BC presentations with integration of conventional dietary therapy and Chinese food therapy. The ultimate goal is to either stabilize glycaemic control or prevent the development of other chronic diseases leading to reduction of disease burden, such as disease-related poor quality of life, stress of healthcare professionals and the rising of healthcare cost.

Dr.Zang Kuntang's Experience in Treating Diabetes

Dr. Zang Kuntang (臧堃堂), professor of the First PLA Military Medical University, has been engaged in the science of traditional Chinese medicine for more than 50 years, with a rich experience accumulated in the treatment of diabetes. It is a great honor for us to have the fortune to follow him in the clinic. The following is a summary of what we have learned from him.

基于糖代谢和胰岛素抵抗评估益气养阴法治疗气阴两虚型2型糖尿病的疗效

目的分析益气养阴法治疗气阴两虚型2型糖尿病对患者糖代谢和胰岛素抵抗评估的影响。方法南京中医药大学附属南京市中西医结合医院2019年6月—2022年3月收治的90例气阴两虚型2型糖尿病患者随机分为胰岛素泵治疗组(45例)和益气养阴治疗组(45例)。益气养阴治疗组采用胰岛素泵强化治疗联合益气养阴法进行治疗,胰岛素泵治疗组单独进行胰岛素泵强化治疗,两组均治疗2周。统计两组治疗2周后的临床疗效及治疗期间不良反应发生情况,比较两组治疗前和治疗2周后中医证候积分、糖代谢情况、胰岛素抵抗情况。结果治疗2周后,益气养阴治疗组总有效率为91.11%(41/45),高于胰岛素泵治疗组[73.33%(33/45),P<0.05]。治疗2周后与治疗前比较,两组口燥咽干、倦怠乏力、失眠、自汗盗汗、五心烦热、气短懒言评分及血清空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(postprandial 2-hour blood glucose,2 h PG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)水平、胰岛素抵抗指数(Homa-IR)降低,益气养阴治疗组低于胰岛素泵治疗组(P<0.05),两组胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛功能指数(Homa-islet)升高,益气养阴治疗组高于胰岛素泵治疗组(P<0.05)。治疗期间,益气养阴治疗组总不良反应发生率与胰岛素泵治疗组比较,差异无统计学意义(P>0.05)。结论气阴两虚型2型糖尿病患者采用益气养阴法进行治疗,可有效改善患者中医证候、糖代谢,降低患者机体胰岛素抵抗程度,具有较好的治疗效果。

Detwmination of Blood Flow in the Lower Leg of Patients withDiabetes Mellitus and the Effects of Treatment with thePrinciple of Vitalizing Blood and Solubilizing Thrombus

Blood flow in the lower leg was determined in 50 cases of non-insulin dependent diabetesmellitus using an XLJ-2 bipolar rheoencephalometry impedance rheogram. In patients with leg pain (85legsi and diabetic foat (15 legs3, the blood flow of the lower leg was decreased as compared withhealthy legs (P<0. 01￣0. 001) . The group with diabetic foot showed a bigger decrease compared withthe leg pain group (PMO. 051 . Atter treatment with the principle of vitalizing blood and solubilizing throm-bus, 22 cases with leg pain (32 legs) showed a significant increase of blood flow in the lower leg (P<0. 001). The group with diabetic foot failed to show any significant increase, indicating the importance ofearly treatment. This method of determining blood flow in the lower leg will help early discovery of abnor-mal changes of blood supply in the lower leg. Treatment with the principle of vitalizing blood and solubiliz-ing thrombus can help improve the conditions of the patients.

健脾安肾汤治疗气阴两虚型糖尿病肾病疗效及对肾纤维化进程延缓作用研究

目的评价健脾安肾汤治疗气阴两虚型糖尿病肾病的疗效以及对肾纤维化进程的延缓作用研究。方法收集115例糖尿病肾病患者,患者均于2019年2月—2021年8月来武汉市中医医院肾病科就诊,对照组56例患者给予西药常规治疗,包括降糖、降压、调脂治疗,并调节饮食习惯,适当运动。口服贝那普利片,5~10 mg/次,1次/d,之后根据患者的病情逐渐增加。观察组共纳入59例患者,其治疗方案是西药常规+健脾安肾汤。两组患者分别治疗14 d。比较治疗疗效,比较两组治疗前后临床症候积分变化、血糖指标(FPG和HbA1c)、肾功能指标(尿微量蛋白、BUN和Scr)、肾纤维化因子指标(TGF-β1、TSP-1和TIMP-1)。结果观察组治疗疗效为91.53%,对照组治疗疗效为80.36%,对照组治疗疗效低于观察组(P<0.05);观察组治疗后水肿、夜尿频多、肢体酸软、周身乏力、苦干舌燥和心内烦热等中医症候积分低于对照组(P<0.05);两组治疗后FPG和HbA1c水平均较治疗前降低(P<0.05),但观察组和对照组治疗后FPG和HbA1c水平比较差异无统计学意义(P>0.05);观察组治疗后尿微量蛋白、BUN和Scr水平低于对照组(P<0.05);观察组治疗后血清TGF-β1、TSP-1和TIMP-1水平低于对照组(P<0.05)。结论健脾安肾汤可用于气阴两虚型糖尿病肾病的治疗,和西药联合使用效果更加,在降低尿白蛋白含量,降低血清TGF-β1、TSP-1和TIMP-1水平,延缓肾纤维进程,保护残余肾功能方面疗效显著,值得临床借鉴。

黄芪竹叶汤配合益气生津丸治疗2型糖尿病气阴两虚证患者的临床观察

目的观察黄芪竹叶汤配合益气生津片治疗2型糖尿病气阴两虚证的临床效果。方法选取2020年1月—2022年1月期间河南省安阳市中医院收治的2型糖尿病(T2DM)患者90例作为研究对象,按随机数字表法分为对照组和治疗组,每组各45例。两组患者均给予常规西药治疗,对照组采用黄芪竹叶汤,治疗组在对照组基础上加用益气生津丸治疗,均连续治疗3个月。观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、血糖指标[空腹血糖(Fasting plasma glucose,FPG),糖化血红蛋白(Glycosylated hemoglobin,HbA1c),空腹胰岛素(Fasting insulin,FINS)]及血清炎性因子[C-反应蛋白(C-reactive protein,CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果治疗后治疗组总有效率91.11%(41/45)明显高于对照组75.55%(34/45),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组各主症及各次症积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血糖指标FPG、FINS、HbA1c均较治疗前降低,差异有统计学意义(P<0.05);且治疗组FPG、FINS、HbA1c均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎性因子水平CRP、IL-6、IL-1β均较治疗前降低,差异有统计学意义(P<0.05);且治疗组CRP、IL-6、IL-1β均低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论黄芪竹叶汤配合益气生津丸是治疗2型糖尿病有效且安全的方案,能明显控制患者血糖,减轻炎症反应。

玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者临床疗效观察

目的:对玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病(T2DM)气阴两虚证患者的临床疗效进行探讨。方法:将60例T2DM患者随机分为对照组(n=30)和观察组(n=30),对照组采用二甲双胍联合德谷门冬双胰岛素治疗,观察组在此基础上应用玉液汤加减治疗,比较2组治疗后的中医证候积分、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、日内平均血糖波动幅度(MAGE)、胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS)。结果:治疗后,观察组总有效率显著高于对照组(93.33%vs 86.67%);观察组中医证候积分、Hb Alc、FPG、2h PG、MAGE和HOMA-IR等指标均低于对照组,HOMA-IS高于对照组(均P<0.05)。结论:玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者疗效显著,可有效控制患者的血糖并改善胰岛功能。

针药并用治疗气阴两虚兼瘀型糖尿病性勃起功能障碍的疗效观察及对血管内皮功能及相关生长因子的影响

目的 观察针刺联合益气养阴活血方治疗气阴两虚兼瘀型糖尿病性勃起功能障碍的临床疗效及对血管内皮功能及相关生长因子的影响。方法 将90例气阴两虚兼瘀型糖尿病性勃起功能障碍患者随机分为治疗组和对照组,每组45例。对照组予糖尿病基础治疗及他达拉非片口服治疗,治疗组在对照组基础上采用针刺联合益气养阴活血方。比较两组国际勃起功能指数-5(international index of erectile function-5, IIEF-5)评分和中医证候积分变化,比较两组血清内皮素-1(endothelin-1, ET-1)、血管紧张素-Ⅱ(angiotensin Ⅱ, Ang-Ⅱ)、一氧化氮(nitric oxide, NO)和血管活性肠肽(vasoactive intestinal peptide, VIP)含量变化,比较两组血清内皮生长因子(vascular endothelial growth factor, VEGF)、转化生长因子-β(transforming growth factor-β, TGF-β)、成纤维细胞生长因子-21(fibroblast growth factor 21, FGF-21)和胰岛素样生长因子-1(insulin-like growth factor 1, IGF-1)含量变化,并比较两组临床疗效。结果 治疗后,两组IIEF-5评分高于治疗前(P<0.05),对照组勃起无力、腰膝酸软、阴部刺痛及中医证候积分总分低于治疗前(P<0.05),治疗组中医证候各项积分及总分低于治疗前(P<0.05);且治疗组IIEF-5评分高于对照组(P<0.05),治疗组中医证候各项积分及总分低于对照组(P<0.05)。治疗后,两组血清ET-1和AngⅡ低于治疗前,NO和VIP高于治疗前(P<0.05);且治疗组血清ET-1和AngⅡ低于对照组,NO和VIP高于对照组(P<0.05)。治疗后,两组血清VEGF和IGF-1高于治疗前,TGF-β和FGF-21低于治疗前(P<0.05);且治疗组血清VEGF和IGF-1高于对照组,TGF-β和FGF-21低于对照组(P<0.05)。治疗组总有效率为90.7%,高于对照组的73.8%(P<0.05)。结论 在西药治疗的基础上,针刺联合益气养阴活血方能够改善气阴两虚兼瘀型糖尿病性勃起功能障碍患者临床症状,提高治疗效果,可能与改善血管内皮功能、调节相关生长因子有关。

运用“虚气留滞”理论辨治糖尿病肾病

糖尿病肾病是糖尿病常见的并发症之一,“虚气留滞”指由于“虚气”日久,气血津液运行不畅,导致“气滞”“痰凝”“血瘀”等“留滞”,反过来“留滞”作为病理产物,阻滞气血津液运行,进一步加重“气虚”。“虚气留滞”理论和糖尿病肾病病因病机密切相关,“虚气”是消渴肾病发病之本,“留滞”为消渴肾病发病之标,治疗上当健脾益肾以治其本,活血化痰解毒以治其标。

糖肾康饮治疗气阴两虚兼瘀型早期糖尿病肾病临床观察

目的:观察糖肾康饮对气阴两虚兼瘀型早期糖尿病肾病患者的临床疗效。方法:将72例气阴两虚兼瘀型早期糖尿病肾病患者按随机数字表法分为治疗组和对照组各36例。对照组进行基础治疗,治疗组在基础治疗的同时口服自拟方糖肾康饮,观察两组患者血糖、肾功能指标及临床疗效。结果:治疗后两组患者空腹血糖(fasting blood glueose,FPG)、餐后2小时血糖(2 hour plasma blood glucose,2h PG)、糖化血红蛋白(glycated haemoglobin,HbA1c)水平、尿微量蛋白排泄率(urine albumin excretionrate,UAER)与微量白蛋白(microalbuminuria,mALB)水平均较治疗前降低(P<0.05),治疗组低于对照组(P<0.05);临床疗效治疗组优于对照组(P<0.05)。结论:基础治疗的同时口服自拟方糖肾康饮可提高气阴两虚兼瘀型早期糖尿病肾病患者中医证候临床疗效,降低血糖,保护肾功能,延缓糖尿病肾病病情进展。

芪蛭益肾胶囊治疗早期糖尿病肾病的多中心前瞻性临床观察

目的:评价芪蛭益肾胶囊治疗糖尿病肾病(DKD)(气阴两虚型)的临床疗效与安全性。方法:采取多中心、区组随机、双盲、安慰剂对照前瞻性研究方法,选取2013年04月—2014年11月全国11所医院478例受试者。采用随机编码表法将患者分为试验组和对照组。试验组口服芪蛭益肾胶囊(1次5粒,1日3次),对照组口服芪蛭益肾胶囊模拟剂(1次5粒,1日3次),共治疗24周,以24 h尿白蛋白排泄率(UAER)作为主要观察指标,并观察24 h尿蛋白定量、肾功能、中医证候评分及不良事件发生情况。结果:治疗后两组UAER均有不同程度下降,但治疗12周、24周后试验组显著低于对照组(P<0.05,P<0.01)。试验组与对照组的UAER下降率在12周末分别为35.81%vs 20.36%(P<0.05),24周后分别为46.08%vs 27.28%(P<0.01),试验组UAER下降率优于对照组。观察结束时试验组UAER较基线下降超过50%的患者比例较对照组多(P<0.05),分别为120(46.51%)vs 30(31.58%)。治疗后试验组24 h尿蛋白定量90.00 mg显著低于对照组131.68 mg(P<0.01)。治疗24周后试验组中医证候疗效为84.5%,显著优于对照组45.26%(P<0.01)。但两组的肾小球滤过率差异无统计学意义(P>0.05),治疗期间两组不良事件发生率差异无统计学意义(P>0.05)。结论:芪蛭益肾胶囊能有效控制DKD(气阴两虚型)尿蛋白,临床使用安全。