摘要
目的:探讨健脾益肾祛瘀汤治疗早期糖尿病肾病(DN)的疗效及对血清炎症因子的影响。方法:将符合研究条件的80例患者,随机按数字表法分为对照组和研究组各40例。对照组服用替米沙坦片,40 mg/次,1次/d。研究组在对照组治疗的基础上加用健脾益肾祛瘀汤,1剂/d。两组疗程均为3个月。记录治疗前治疗后24 h尿微量白蛋白排泄率(UAER),血清肌酐(SCr),尿素氮(BUN),24 h尿蛋白定量(24 h UPQ),尿微量白蛋白与肌酐的比值(ACR)和胱抑素C(Cys C);进行脾肾不足,血瘀阻络证评分;检测治疗前后高敏C-反应蛋白(hs-CRP),白介素-6(IL-6),肿瘤坏死因子(TNF-α)水平。结果:研究组临床疗效总有效率为75%,对照组为52.5%,研究组高于对照组(P<0.05);治疗后研究组SCr,BUN,24 h UPQ,UAER,ACR和Cys C均低于对照组(P<0.01);研究组在治疗后第1,2,3个月脾肾不足,血瘀阻络证评分均逐渐下降,并低于同期对照组(P<0.01);治疗后研究组脾肾不足,血瘀阻络证评分下降幅度多于对照组(P<0.01);研究组治疗后血清hs-CRP,IL-6,TNF-α均低于对照组(P<0.01)。结论:在西医常规治疗的基础上,加用健脾益肾祛瘀汤能改善早期DN肾功能,减轻蛋白尿,降低肾小球滤过率,减轻临床症状,减轻炎症反应,临床疗效优于单纯的西医综合治疗措施。
Objective： To discuss the clinical efficacy of Jianpi Yishen Quyu decoction in treating diabetic nephropathy （DN） and its effect on serum levels of inflammatory factors. Method： Eighty patients were randomly divided into control group （40 cases） and research group （40 cases） by random number table. Patients in control group took telmisartan tablets, 40 mg/time, 1 time/day. In addition to the therapy of control group, patients in research group were given Jianpi Yishen Quyu decoction, 1 dose/day. Treatment courses in two groups lasted for 3 months. Before and after treatment, 24-hour urine protein quantitation （24 h UPQ）, ratio of microalbuminuria and creatinine （ACR） and cystatin C （CysC） were recorded. And spleen and kidney deficiency and blood stasis blocking collaterals were scored. Levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were detected. Result： Total effective rate in research group was 75% , which was superior to 52.5% of control group （P 〈0.05）. After the treatment, the SCr, BUN, 24 h UPQ, UAER, ACR and CysC in the research group were inferior to these in control group （P 〈0.01）. The scores of spleen and kidney deficiency and blood stasis and collateral blocking symptoms in research group reduced to below these in control group at the first, second and third months after the treatment （P 〈0.01 ）. The scores of spleen and kidney deficiency and blood stasis and collateral blocking in research group decreased faster than that in control group after treatment （P 〈 0.01 ）. Levels of serum hs-CRP, IL-6, TNF-a in research group were lower than these standards in control group （P 〈 0.01 ）. Conclusion： In addition to the conventional western medicine therapy, Jianpi Yishen Quyu decotion can be administered to improve DN renal function at early stage, reduce albuminuria and glomerular filtration rate, relieve the clinical Symptoms and inflammation reaction. Its clinical c
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2015年第18期183-186,共4页
Chinese Journal of Experimental Traditional Medical Formulae
基金
山东省科技发展计划项目(20130616)
关键词
糖尿病肾病
健脾益肾祛瘀汤
肾功能
diabetic nephropathy
Jianpi Yishen Quyu decotion
renal function
