自拟滋肾方结合西医常规疗法治疗气阴两虚型IV期糖尿病肾病

目的：评价自拟滋肾方结合西医常规疗法治疗气阴两虚型 IV 期糖尿病肾病(diabetic nephropathy, DN)的疗效。方法将112例气阴两虚型IV期DN患者按随机数字表法分为2组各56例。常规治疗组给予降糖、降压、调脂和控制饮食等治疗，联合治疗组在对照组基础上加服自拟滋肾方，均治疗3个月。采用全自动生化分析仪检测血尿素氮(blood urea nitrogen, BUN)、血肌酐(serum creatinine, SCr)、TG、TC、LDL-C、HDL-C、HbA1c；采用ELISA检测尿白蛋白排泄率(urinary albumin excretion rate, UAER)。结果治疗后，联合治疗组SCr(53.51±18.12)μmol/L比(62.66±21.14)μmol/L；t＝2.459，P＜0.05]、UAER(100.73±84.24)μg/min比(156.24±96.38)μg/min；t＝3.245，P＜0.05]、TG(1.73±0.22)mmol/L比(2.06±0.21)mmol/L；t＝8.112，P＜0.01]、TC(4.56±0.62)mmol/L 比(5.10±0.31)mmol/L；t＝5.830， P＜0.01]、LDL-C(2.42±1.05)mmol/L比(3.31±0.81)mmol/L；t＝5.022，P＜0.01]较常规治疗组显著降低，而 HDL-C(1.67±0.33)mmol/L 比(1.36±0.41)mmol/L；t＝4.460，P＜0.01]显著增高。结论在常规治疗基础上加用自拟滋肾方，可改善气阴两虚IV期DN患者的SCr和UAER，并有效调节血脂水平。

Zishendecoction combined with standard treatment of western medicine for stage IV diabetic nephropathy with Qi and Yin deficiency

ObjectiveTo evaluate the therapeutic effect ofZishen decoction combined with standard treatment of western medicine for for stage IV diabetic nephropathy with Qi and Yin deficiency.MethodsA total of 112 patients with stage IV diabetic nephropathy and Qi and Yin deficiency were randomized to thestandard treatment and the combined treatment groups, 56 in each. The standard treatment group received conventional treatment, including blood glucose controlling, antihypertensive, blood lipid regulating and diet controlling. The combined treatment group receivedZishen decoction on the basis of conventional treatment. All the patients were treated for 3 months. The blood urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TG), triacylglycerol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and glycated hemoglobin (HbA1c) were measured by an automatic chemistry analyzer. The urinary albumin excretion rate (UAER) was measured by the enzyme-linked immunosorbent assay.ResultsCompared with the standard treatment group, the SCr (53.51 ± 18.12μmol/Lvs. 62.66 ± 21.14μmol/L;t=2.459,P<0.05), UAER(100.73±84.24μg/minvs. 156.24 ± 96.38μg/min;t=3.245,P<0.05), TG(1.73±0.22 mmol/Lvs. 2.06 ± 0.21 mmol/L;t=8.112,P<0.01), TC(4.56 ± 0.62 mmol/Lvs. 5.10 ±0.31 mmol/L;t=5.830, P<0.01), LDL-C (2.42 ± 1.05 mmol/Lvs. 3.31 ± 0.81 mmol/L;t=5.022,P<0.01) in the combined treatment group decreased significantly, and the HDL-C (1.67 ± 0.33 mmol/Lvs. 1.36 ± 0.41 mmol/L;t=4.460,P<0.01) increased significantly. ConclusionZishen decoction on the basis of conventional treatment can improve the SCr and UAER, and regulate the blood lipid in the patients with stage IV diabetic nephropathy and Qi-Yin deficiency.