摘要
目的:观察参芪地黄汤化裁方对Ⅳ期糖尿病肾病(diabetic nephropathy,DN)患者尿蛋白、同型半胱氨酸(homocysteine,HCY)、超氧化物歧化酶(superoxide dismutase,SOD)及临床进展的影响。方法:回顾性纳入气阴两虚夹瘀型Ⅳ期DN患者68例,对照组给予基础性治疗,治疗组在对照组基础上加用参芪地黄汤化裁方治疗,两组患者疗程均为1年。观察两组治疗前后的血糖指标[空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2-hour postprandial glucose,2hPG)、糖化血红蛋白(glycosylated Hemoglobin,HbA1c)]、血压[收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)]、生化指标[血浆白蛋白(plasma albumin,ALB)、血尿酸(uric acid,UA)、胆固醇(cholesterol,CHO)、三酰甘油(triglyceride,TG)、尿素氮(boold urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)、尿蛋白定量(urine total protein quantity,UTP)]、HCY、SOD,估算肾小球滤过率(estimated Glomerular Filtration Rate,eGFR)的变化情况以及发展为慢性肾功能衰竭的情况,并评价中医证候积分及临床疗效。结果:治疗组患者治疗1年后,有效率为84.4%(27/32),对照组为61.1%(22/36),两组比较差异有统计学意义(P<0.05);治疗组腰膝酸软、倦怠乏力、双下肢浮肿、尿浊及证候总积分较对照组降低,差异有统计学意义(P<0.01);治疗组2h PG、Hb A1c水平低于对照组,差异有统计学意义(P<0.01或P<0.05);治疗组ALB水平优于对照组,差异有统计学意义(P<0.05);治疗组较对照组BUN、SCr升高的幅度降低,差异有统计学意义(P<0.05);治疗组较对照组e GFR下降的幅度降低,差异有统计学意义(P<0.01);治疗组HCY、SOD水平均优于对照组,差异有统计学意义(P<0.01);治疗组UTP水平优于对照组,差异有统计学意义(P<0.05);同时治疗组较对照组进入慢性肾功能衰竭的患者明显减少,差异有统计学意义(P<0.05)。结论:参芪地黄汤化裁方辅助治疗能有效改善Ⅳ期DN气阴�
Objective:To observe the effect of modified Shenqi Dihuang Decoction on urinary protein,homocysteine(HCY),superoxide dismutase(SOD)and clinical progress in patients with diabetic nephropathy(DN).Methods:68 patients with stage IV DN of qi and yin deficiency with blood stasis syndrome were retrospectively included.The control group was given basic treatment of DN,while the treatment group was treated with Shenqi Dihuang Decoction on the basis of the control group.The course of treatment of both groups was 1 year.The blood glucose indicators[fasting plasma glucose(FPG),2-hour postprandial glucose(2 hPG),glycosylated Hemoglobin(HbA1 c)],blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],biochemical indicators[plasma albumin(ALB),uric acid(UA),cholesterol(CHO),triglyceride(TG),boold urea nitrogen(BUN),serum creatinine(SCr),urine total protein quantity(UTP)],HCY,SOD,estimated Glomerular Filtration Rate(eGFR)changes and the number of chronic renal failure cases of the two groups before and after treatment were observed,and TCM syndrome scores and clinical efficacy were evaluated.Results:After 1 year of treatment in the treatment group,the effective rate of the treatment group was 84.4%(27/32)and the control group was 61.1%(22/36).The difference between the two groups was statistically significant(P<0.05);Soreness,fatigue,fatigue,edema of lower extremities,turbid urine and total syndrome scores were lower than those of the control group,the difference was statistically significant(P<0.01);the 2 hPG and HbA1 c levels of the treatment group were lower than those of the control group,and the difference was statistically significant(P<0.01 or P<0.05);the ALB level of the treatment group was better than the control group,and the difference was statistically significant(P<0.05);The increase of BUN and SCr in the control group decreased,and the difference was statistically significant(P<0.05);the reduction of eGFR in the treatment group was lower than that in the control group,and the difference was stat
作者
吕翠岩
贾晓蕾
李倩
刘铜华
LYU Cuiyan;JIA Xiaolei;LI Qian;LIU Tonghua(Beijing Hospital of Chinese Medicine Affiliated to Capital Medical University,Beijing China 100010;The Third Mfiliated Hospital of Beijing University of Chinese Medicine,Beijing China 100029;Beijing University of Chinese Medicine,Beijing China 100029)
出处
《中医学报》
CAS
2020年第11期2433-2438,共6页
Acta Chinese Medicine
基金
国家重大新药创制项目(2012ZX09102201-001)
教育部博士点基金立项课题项目(20110013130001)
北京中医药大学创新团队项目(2011-CXTD-19)
首都医科大学科研培育基金项目(PYZ2017140)
北京市属医院科研培育计划项目(PZ2017017)。
