益气养阴消癥通络方治疗早期糖尿病肾病临床观察

目的观察益气养阴消癥通络方对早期糖尿病肾病的治疗效果。方法 78例早期糖尿病肾病患者,按随机数字表法分为治疗组(益气养阴消癥通络方组)39例及对照组(厄贝沙坦组)39例,经1年治疗后,观察疗效、中医证候积分、尿白蛋白排泄率(UAER)、血清肌酐(SCr)、血尿素氮(BUN)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)及终点事件发生率。结果治疗组总有效率为83.8%(31/37),对照组为60.5%(23/38),两组比较差异有统计学意义(P<0.05);治疗组治疗后中医证候积分较本组治疗前及对照组治疗后明显下降(P<0.05,P<0.01)。治疗组UAER、SCr、BUN、FBG、TC及TG治疗后分别为:(65.78±9.67)μg/min,(93.20±12.99)μmol/L,(5.69±1.21)mmol/L,(6.14±1.47)mmol/L,(4.85±0.83)mmol/L,(1.46±0.81)mmol/L,均显著低于治疗前[(161.03±20.01)μg/min,(101.11±14.33)μmol/L,(6.54±1.12)mmol/L,(9.27±2.32)mmol/L,(6.19±2.13)mmol/L,(2.70±1.86)mmol/L](P<0.05,P<0.01);对照组治疗后上述指标亦有改善(P<0.05,P<0.01);治疗组治疗后较对照组TC、TG[(5.58±1.57)mmol/L,(1.99±1.22)mmol/L]降低更明显(P<0.05)。治疗组的终点事件(1年后进入临床糖尿病肾病)发生率(5.4%,2/37)低于对照组(10.5%,4/38),但差异无统计学意义。结论益气养阴消癥通络方结合西医基础治疗早期糖尿病肾病有较好的疗效。

Clinical Observation of Treating Early Diabetic Nephropathy by Qi Supplementing,Yin Nourishing,Blood Stasis Dispersing,Collateral Dredging Recipe

Objective To observe therapeutic effects of qi supplementing,yin nourishing,blood stasis dispersing,collateral dredging recipe(QYBCR) on early diabetic nephropathy(DN).Methods Seventy-eight early DN patients were randomly assigned to the treatment group(39 cases,treated by QYBCR) and the control group(39 cases,treated by irbesartan).The changes of the therapeutic efficacy,Chinese medicine syndrome scores,urine albumin excretion rate(UAER),serum creatinine(SCr),blood urine nitrogen(BUN),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),and the occurrence of end-point events were observed after one-year treatment.Results The total effective rate in treatment group was 83.8%(31/37 cases),which was obviously higher than that in control group(60.5%,23/38 cases)(P<0.05).After treatment the Chinese medicine syndrome scores were reduced significantly in the treatment group(P<0.05,P<0.01),and showed significant difference when compared with those in the control group(P<0.05,P<0.01).Levels of UAER,SCr,BUN,FBG,TC,and TG were(65.78±9.67) μg/min,(93.20±12.99) μmol/L,(5.69±1.21) mmol/L,(6.14±1.47) mmol/L,(4.85±0.83) mmol/L,(1.46±0.81) mmol/L after treatment in treatment group.All of them decreased more significantly than before treatment [(161.03±20.01) μg/min,(101.11±14.33) μmol/L,(6.54±1.12) mmol/L,(9.27±2.32) mmol/L,(6.19±2.13) mmol/L,(2.70±1.86) mmol/L](P<0.05,P<0.01).The aforesaid indices were also improved in the control group after treatment(P<0.05,P<0.01).The reduction of TC and TG after treatment in the treatment group was more significant [(5.58±1.57) mmol/L,(1.99±1.22) mmol/L](P<0.05).Besides,the incidence rate of end-point events(5.4%,2/37)(1 year after the development of clinical DN) of the treatment group was slightly lower than that of the control group(10.5%,4/38),but with no statistical difference.Conclusion QYBCR combined with Western medicine-based treatment showed better therapeutic efficacy on early DN.