防己黄芪汤加味治疗糖尿病肾病疗效及对患者糖脂代谢、氧化应激的影响

目的: 探讨防己黄芪汤加味治疗糖尿病肾病(气虚湿阻证)疗效及对患者患者糖脂代谢及氧化应激的影响。方法:选择98例气虚湿阻证糖尿病肾病患者为研究对象,按随机数字表法分为对照组和治疗组,每组49例。对照组采用常规西药治疗,治疗组在对照组的基础上采用防己黄芪汤加味治疗,两组均持续治疗4个疗程。对比两组治疗前后气虚湿阻证中医症候评分、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血浆内皮素(ET)、血清尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白(24 h Upr)、超氧化物歧化酶(SOD)、丙二醛(MDA),比较两组临床疗效、治疗期间不良反应发生情况,统计两组终点事件发生情况。结果:两组患者治疗后气虚湿阻证中医症状评分、FBG、HbA1c、TG、LDL-C、ET、BUN、Scr、24 h Upr、MDA水平均降低(P<0.05),且治疗组更低(P<0.05); 两组患者治疗后SOD水平均升高(P<0.05),且治疗组更高(P<0.05); 随访期间,两组均无肾衰竭住院、尿毒症透析等终点事件发生; 两组治疗期间不良反应发生率相近(P>0.05); 治疗组总有效率比对照组高(87.76%与71.43%,P<0.05)。结论:防己黄芪汤加味联合常规西药治疗糖尿病肾病(气虚湿阻证)患者,改善患者的临床症状,可改善患者的糖脂代谢功能、肾功能,调节氧化应激指标。

Effect of Fangji Huangqi decoction on diabetic nephropathy and its influence on glucose and lipid metabolism and oxidative stress

Objective:To explore the curative effect of Fangji Huangqi decoction in the treatment of diabetic nephropathy(Qi deficiency and dampness syndrome)and its influence on glucose and lipid metabolism and oxidative stress.Methods:A total of 98 patients with diabetic nephropathy with Qi deficiency and dampness obstruction syndrome were selected as the research objects.They were divided into a control group and a treatment group according to a random number table,with 49 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with Fangji Huangqi decoction on the basis of the control group.Both groups were treated continuously for 4 courses.The Chinese medicine syndrome scores,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),plasma endothelin(ET),fasting blood glucose(FBG),glycated hemoglobin(HbA1c),low-density lipoprotein cholesterol(LDL-C),plasma endothelin(ET),serum urea nitrogen(BUN),blood creatinine(Scr),24 h urine protein(24 h Upr),superoxide dismutase(SOD),malondialdehyde(MDA)were compared between the two groups before and after treatment.The clinical efficacy and the occurrence of adverse reactions during the treatment period were compared between the two groups,the two groups' endpoint events were counted.Results:After treatment,the Chinese medicine symptom scores,FBG,HbA1c,TG,LDL-C,ET,BUN,Scr,24 h Upr and MDA levels of the two groups of patients with Qi deficiency and dampness obstruction syndrome decreased(P<0.05),and the treatment group was even lower(P< 0.05).After treatment,the SOD level of the two groups of patients increased(P<0.05),and the treatment group was higher(P<0.05).During the follow-up period,there were no end-point events such as renal failure hospitalization and uremic dialysis in the two groups; the incidence of adverse reactions during the treatment period of the two groups was similar(P>0.05).The total effective rate of the treatment group is higher than that of the control group(87.76% vs.71.43%,P<0.05).Conclusion:Fangji Huangqi decoction combined with conventional western medicine can improve the clinical symptoms of patients with diabetic nephropathy(Qi deficiency and dampness stagnation).It can improve the patient's glucose and lipid metabolism,renal function,and regulate oxidative stress.