摘要
目的观察温脾补肾泄浊汤联合厄贝沙坦片治疗糖尿病肾病脾肾阳虚兼血瘀证的疗效及对血液流变学和肾脏纤维化指标水平的影响。方法将100例糖尿病肾病脾肾阳虚兼血瘀证患者按照随机数字表法分为2组,对照组50例予厄贝沙坦片+西医常规治疗,治疗组50例在对照组治疗基础上加用温脾补肾泄浊汤。2组均治疗30 d。比较2组疗效;比较2组治疗前后肾功能指标尿白蛋白排泄率(UAER)、内生肌酐清除率(CCr)和β_(2)微球蛋白(β_(2)-MG)变化;比较2组治疗前后凝血功能指标凝血酶时间(TT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)变化;比较2组治疗前后血液流变学指标全血黏度(高切)、全血黏度(中切)、全血黏度(低切)、血细胞比容(HCT)、红细胞沉降率(ESR)、血流方程K值、血浆黏度及红细胞聚集指数变化;比较2组治疗前后肾脏纤维化指标血胱抑素C(Cys-C)、基质金属蛋白酶抑制剂-1(T1MP-1)、转化生长因子β_(1)(TGF-β_(1))、Ⅳ型胶原(CⅣ)变化。结果治疗组总有效率86.00%(43/50),对照组总有效率68.00%(34/50),治疗组疗效优于对照组(P<0.05)。2组治疗后UAER、β_(2)-MG水平均较本组治疗前降低(P<0.05),CCr水平较本组治疗前升高(P<0.05);治疗后治疗组UAER、β_(2)-MG水平均低于对照组(P<0.05),CCr水平高于对照组(P<0.05)。2组治疗后TT、APTT均较本组治疗前升高(P<0.05),FIB较本组治疗前降低(P<0.05);治疗后治疗组TT、APTT均高于对照组(P<0.05),FIB低于对照组(P<0.05)。2组治疗后全血黏度(中切)、HCT、全血黏度(高切)、ESR、全血黏度(低切)、血流方程K值、红细胞聚集指数、血浆黏度均较本组治疗前降低(P<0.05),治疗后治疗组全血黏度(中切)、HCT、全血黏度(高切)、ESR、全血黏度(低切)、血流方程K值、红细胞聚集指数、血浆黏度均低于对照组(P<0.05)。2组治疗后Cys-C、TIMP-1、TGF-β_(1)、CⅣ均较本组治疗前降低(P<0.05),治�
Objective To observe the curative effect of Wenpi Bushen Xiezhuo Decoction combined with irbesartan for diabetic nephropathy(DN)of spleen kidney yang deficiency and blood stasis and its influence on hemorheology and renal fibrosis indexes.Methods A total of 100 DN patients(spleen kidney yang deficiency and blood stasis)were randomly assigned into the treatment group(n=50)and the control group(n=50).All patients were managed by irbesartan+conventional Western medicine,and those in the treatment group were additionally treated with Wenpi Bushen Xiezhuo Decoction.The treatment continued 30 days to compare renal function indexes(urinary albumin excretion rate[UAER],endogenous creatinine clearance[CCr],beta 2-microglobulin[β_(2)-MG]),coagulation function indexes(thrombin time[TT],activated partial thromboplastin time[APTT],fibrinogen[FIB]),hemorheology indexes(whole blood viscosity[WBV][high shear],WBV[middle shear],WBV[low shear],packed-cell volume[HCT],erythrocyte sedimentation rate[ESR],sedimentation equation k value,plasma viscosity[PV],red cell aggregation[RCA]),renal fibrosis indexes(cystatin C[Cys-C],tissue inhibitor of metalloproteinase 1[TIMP-1],transforming growth factor-beta1[TGF-β_(1)],collagen typeⅣ[CⅣ]).The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(86.00%[43/50]vs 68.00%[34/50],[P<0.05],respectively).After treatment,UAER andβ_(2)-MG in the both groups were decreased(P<0.05),which were lower in the treatment group than in the control group(P<0.05);CCr in the both groups was increased(P<0.05),which was increased in the treatment group compared with the control group(P<0.05);TT and APTT in the both groups were increased(P<0.05),while FIB was decreased(P<0.05);higher TT and APTT,and lower FIB were detected in the treatment group than those of the control group(all P<0.05);hemorheology indexes in the both groups were decreased(P<0.05),the reduction in the treatment group was more prevalent relative to the control gro
作者
李红霞
刘晓宇
魏田静
庞丽
王亚立
于向慧
LI Hongxia;LIU Xiaoyu;WEI Tianjing;PANG Li;WANG Yali;YU Xianghui(Department of Endocrinology,The Second Affiliated Hospital of Hebei University of Chinese Medicine,Dingzhou,Hebei 073000;Department of Endocrinology,Hebei Hospital of Traditional Chi-nese Medicine,Shijiazhuang,Hebei 050011)
出处
《河北中医》
2022年第12期2036-2041,共6页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2022年度中医药类科研计划课题(编号:2022402)。
关键词
糖尿病肾病
中西医结合疗法
Diabetic nephropathy
Integrated traditional Chinese and Western medicine therapy
