益肾降浊冲剂对脾肾气虚型糖尿病肾病Ⅲ期患者尿微量白蛋白的影响

目的：观察益肾降浊冲剂对脾肾气虚型糖尿病肾病（diabetic kidney disease,DKD）Ⅲ期患者的临床疗效及对尿微量白蛋白的影响,探讨益肾降浊冲剂在治疗糖尿病肾病中的作用机制。方法：根据丹麦学者Mogensen糖尿病肾病诊断和分期标准,选取DKDⅢ期患者80例。采用随机对照方法,将80例患者随机分为两组,对照组（40例）单纯用现代医学常规疗法治疗;治疗组（40例）在现代医学常规治疗基础上给予口服益肾降浊冲剂每次10g,1天3次。两组均以2个月为1疗程,观察两组患者治疗前后中医临床症状积分、肝功能、肾功能、尿微量白蛋白水平变化。结果：对照组有2例、治疗组有3例患者因失访未完成观察。两组患者治疗后肾功能较治疗前均未见明显改善（P〉0.05）;治疗组患者中医症状积分较治疗组改善更为明显（P〈0.05）;治疗组与对照组相比尿微量白蛋白下降更明显（P〈0.05）;两组患者治疗期间均未见明显副作用。结论：益肾降浊冲剂加常规西药治疗能降低脾肾气虚型DKDⅢ期患者尿微量白蛋水平,改善临床症状。

Clinical effect of Yishenjiangzhuo Granule on Patients with Diabetic Kidney Disease and Effect on Microalbuminuria

Objective：To observe the clinical effect of Yishenjiangzhuo Granule on patients of Spleen and Kidney Qi Deficiency with Diabetic Kidney Disease and the effect of 24h urinary albumin excretion. Methods：According to the diagnostic criterion of Mogensen DKD Classification. 80 patients graded Ⅲ with DKD were enrolled and randomly divided into treatment group and control group at random,treatment group is 40 cases and control group is 40 cases, Patients of treatment group took the Yishenjiangzhuo Granule three pouches（10 gram/pouch） per day and integrated with western medicine, Patients of control group were given western medicine only. One course of treatment was two months. Clinic symptoms、renal function and 24h urinary albumin excretion were evaluated before and after treatment. Results：2 cases and 3 cases missed during the study. The scores of TCM clinic symptoms of treatment group decreased much more than that of control group after treatment （P0.05）;and 24 h urinary albumin excretion of treatment group decreased more than that of treatment group （P0.05）;No obvious adverse reaction was found in both groups. Conclusion：Treatment of Yishenjiangzhuo Granule integrated with western medicine could reduce the level of microalbuminuria and alleviated clinic symptoms.