益肾化瘀祛湿汤治疗糖尿病肾病的临床观察

目的探讨益肾化瘀祛湿汤治疗糖尿病肾病（DN）的临床疗效。方法将60例DN患者随机分为2组。治疗组30例予益肾化瘀祛湿汤治疗,对照组30例予厄贝沙坦片治疗。2组均8周为1个疗程,共治疗2个疗程,随访8周后统计疗效。观察项目：①临床症状、体征积分 ②空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc） ③血脂：胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C） ④血液流变学指标 ⑤24h尿蛋白定量、血肌酐（Cr）和内生肌酐清除率（Ccr）。结果治疗组总有效率76.7%,对照组总有效率36.7%,2组比较差异有统计学意义（P〈0.05） 2组治疗后血糖（FPG、2hPG、HbAlc）、血液流变学指标及临床症状、体征积分与本组治疗前比较差异均有统计学意义（P〈0.05,P〈0.01）,且治疗组改善情况优于对照组（P〈0.05,P〈0.01） 治疗组治疗后TC、TG和HDL-C与本组治疗前比较差异均有统计学意义（P〈0.05,P〈0.01）,对照组治疗后TC、TG与本组治疗前比较差异均有统计学意义（P〈0.05,P〈0.01）,治疗组TC、TG和HDL-C的改善情况均优于对照组（P〈0.05） 治疗组治疗后24h尿蛋白定量、Cr和Ccr与本组治疗前比较差异均有统计学意义（P〈0.05,P〈0.01）,对照组24h尿蛋白定量治疗前后比较差异有统计学意义（P〈0.05）,治疗组24h尿蛋白定量、Cr改善情况优于对照组（P〈0.05）。结论益肾化瘀祛湿汤可调节血糖和脂类代谢紊乱,调整血液流变学异常,减少尿蛋白的排泄,调整肾小球滤过功能,延缓DN的进展。

Observation of Yishenhuayuqushi decoction on diabetic nephropathy WEI

Objective To evaluate the effect of Yishenhuayuqushi decoction on diabetic nephropathy. Methods 60 cases of diabetic nephropathy （DN） were randomly divided into two groups. Patients in treatment group （ n = 30） were treated by Yishenhuayuqushi decoction. Patients in control group （ n = 30） were treated by Irbesartan. The therapeutic course was eight weeks in two groups. The effect was evaluated after 8 weeks follow - up. The indexes observed included clinical symptoms, sign score, FPG, 2 hPG, HbAlc, blood lipid, TC, TG, HDL- C, hemorrheology, 24hrUprV, SCr and CrC1. Results The total effective rate in treatment group （76.7%） was higher than that in control group （36.7%, P 〈0.05）. FPG, 2hPG, HbAle, hemorrheology, clinical symptoms and sign score were improved significantly after treatment in two groups （ P 〈 0.05, P 〈 0.01 ）. Improvement of these indexes in treatment group was superior to that in control group （ P 〈 0.05, P 〈 0.01 ）. Improvements of TC, TG, HDL - C, 24hrUprV, SCr and CIC1 in treatment group were superior to those in control group （ P 〈 0.05, P 〈 0.01 ）. Conclusion Yishenhuayuqushi decoction can regulate blood sugar, lipid metabolism, and hemorrheology abnormity, decrease excretion of Urine protein, delay progress of diabetic nephropathy.