摘要
目的:观察降糖保肾方联合西医疗法治疗Ⅲ~Ⅳ期糖尿病肾病患者的临床疗效。方法:将60例糖尿病肾病患者随机分为治疗组和对照组各30例,对照组予糖尿病肾病常规治疗,治疗组在对照组治疗基础上加服降糖保肾方。2组疗程均为60天,比较2组患者的临床疗效,观察治疗前后中医证候积分、肾功能指标[血肌酐(SCr)和尿素氮(BUN)]、尿纤维粘连蛋白(FN)、尿Ⅳ型胶原(Col-Ⅳ)、24 h尿蛋白定量的变化。结果:治疗后,治疗组总有效率高于对照组(P<0.05)。2组中医证候积分均较治疗前下降,治疗组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。对照组SCr、BUN水平降低不明显,与治疗前比较,差异均无统计学意义(P>0.05)。治疗组SCr水平较治疗前降低(P<0.05),并低于对照组(P<0.05),而BUN水平与治疗前比较无统计学差异(P>0.05)。对照组尿FN、Col-Ⅳ水平治疗前后比较,差异均无统计学意义(P>0.05),24 h尿蛋白定量较治疗前减少,差异有统计学意义(P<0.05);治疗组治疗后3项指标值均较治疗前减少,并且低于对照组,差异均有统计学意义(P<0.05)。结论:降糖保肾方可使患者的肾功能得到保护,有效改善临床症状,其机制可能是通过降低尿液中FN、Col-Ⅳ水平,从而在一定程度上减轻肾小球细胞外基质的过度积聚,改善患者的临床症状,延缓肾功能恶化。
Objective： To observe the clinical effect of Jiangtang Baoshen prescription combined with western medicine therapy for diabetic nephropathy at stage Ⅲ and Ⅳ. Methods： Divided 60 cases of patients with diabetic nephropathy into the treatment group and the control group randomly, 30 cases in each group. Both groups received the routine therapy of diabetic nephropathy, while the treatment group additionally received Jiangtang Baoshen prescription orally. The course in both groups lasted for 60 days. Compared the clinical effect between the two groups, and observed Chinese medicine（CM） syndrome scores, renal function indexes [serum creatinine（SCr） and blood urine nitrogen（BUN）], urine fibronectin（FN）, urinary type IV Collagen （Col-IV ）, and quantitative urinary protein in 24 hours. Results： After treatment, the total effective rate in the treatment group was higher than that in the control group（P〈0.05）. CM syndrome scores in both groups were lower than those before treatment, and CM syndrome scores in the treatment group were lower than those in the control group, differences being significant （P 〈0.05）. Levels of SCr and BUN in the control group were not significantly decreased when comparing with those before treatment（P 〉 0.05）. SCr levels in the treatment group were lower than those before treatment （P〈 0.05） and were also lower than those in the control group（P〈 0.05）, while the comparison of BUN levels after treatment with those before treatment showed no significance in differences（P 〉 0.05）. Compared levels of urine FN and urinary Col-IV in the control group before and after treatment, there was no significance being found in differences（P 〉 0.05）. Quantitative urinary protein in 24 hours of the control group was less than that before treatment（P〈0.05）. Those three indexes of the treatment group after treatment were all lower than those before treatment, and were all lower than those of the control group. Conclusion： Jiangtang Ba
出处
《新中医》
CAS
2017年第12期58-61,共4页
New Chinese Medicine
基金
温州市科技计划项目(Y20160204)
浙江省中医药科学研究基金项目(2015ZA198)
关键词
糖尿病肾病(DN)
气阴两虚证
湿瘀阻络证
中西医结合疗法
降糖保肾方
纤维粘连蛋白(FN)
Ⅳ型胶原(Col-Ⅳ)
肾功能
Diabetic nephropathy （DN）
Qi-yin deficiency syndrome
Dampness-blood stasis blockage syndrome
Integrated Chinese and western medicine therapy
Jiangtang Baoshen prescription
Fibronectin（FN）
Type IV collagen（Col-IV）
Renal function
