摘要
目的探讨健脾温肾活血方联合厄贝沙坦治疗糖尿病肾脏疾病的疗效及对肾功能、血清炎症因子的影响。方法选择2021年10月—2023年3月河北中医药大学第一附属医院内分泌科门诊及住院诊治的脾肾阳虚兼血瘀型Ⅲ~Ⅳ期糖尿病肾脏疾病患者100例,随机分为观察组和对照组各50例,对照组在西医常规治疗基础上给予厄贝沙坦片治疗,观察组在对照组治疗基础上给予健脾温肾活血方治疗,2组均连续治疗12周。比较2组治疗前后的中医证候积分、生活质量[采用修订版糖尿病特异性生存质量量表(A-DQOL)评估]、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、肾功能指标[血肌酐(SCr)、尿蛋白排泄率(UAER)、肾小球滤过率(eGFR)、β_(2)微球蛋白(β_(2)-MG)、胱抑素C(Cys C)]、炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,评估2组临床疗效及不良反应发生情况。结果2组治疗后中医证候积分、A-DQOL评分及FPG、2hPG、HbA1c、SCr、UAER、β_(2)-MG、Cys C、IL-6、TNF-α水平均明显低于治疗前(P均<0.05),且观察组治疗后上述指标均明显低于对照组(P均<0.05);2组治疗后eGFR均明显高于治疗前(P均<0.05),且观察组明显高于对照组(P<0.05)。治疗12周后观察组总有效率为88%(44/50),明显高于对照组的68%(34/50),差异有统计学意义(P<0.05)。2组治疗期间均未发生与服用药物明显相关的不良反应。结论健脾温肾活血方联合厄贝沙坦治疗脾肾阳虚兼血瘀型Ⅲ~Ⅳ期糖尿病肾脏疾病疗效确切,可明显改善肾功能,减轻炎症反应,抑制肾脏炎性损伤,提高患者生活质量。
Objective It is to explore the efficacy of decoction for fortifying spleen,warming kidney and activating blood combined with irbesartan in the treatment of diabetic kidney disease and its effects on renal function and serum inflammatory factors.Methods One hundred patients with stageⅢ~Ⅳdiabetic kidney disease of syndrome of spleen-kidney Yang deficiency with blood stasis were selected from outpatient clinics and hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine from October 2021 to March 2023,and were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with irbesartan tablets on the basis of conventional western medicine treatment,while the observation group was treated with decoction for fortifying spleen,warming kidney and activating blood on the basis of the control group,both groups were continuously treated for 12 weeks.The scores of Chinese medicine syndrome,quality of life[assessed by Adjusted Diabetes Quality of Life(A-DQOL)],levels of blood glucose indexes[fasting plasma glucose(FPG),2-h postprandial glucose(2hPG),glycosylated hemoglobin(HbA1c)],renal function indexes[serum creatinine(SCr),urinary excretion rate(UAER),glomerular filtration rate(eGFR),β_(2) microglutaments(β_(2)-MG),cystatin C(Cys C)],and inflammation indexes[(interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]of the two groups before and after treatment were compared,and the clinical efficacy and occurrence of adverse reactions of the two groups were assessed.Results The scores of Chinese medicine syndrome,A-DQOL scores and the levels of FPG,2hPG,HbA1c,SCr,UAER,β_(2)-MG,Cys C,IL-6 and TNF-αof the two groups were significantly lower after treatment than those before treatment(all P<0.05),and the above indexes of the observation group after the treatment were significantly lower than those of the control group(all P<0.05);The eGFRs of the two groups were significantly higher after trea
作者
张超畅
张庚良
李凯璇
何艳玲
杨雨菲
刘玉洁
赵奥琪
ZHANG Chaochang;ZHANG Gengliang;LI Kaixuan;HE Yanling;YANG Yufei;LIU Yujie;ZHAO Aoqi(The First Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)
出处
《现代中西医结合杂志》
CAS
2024年第10期1344-1350,1384,共8页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
河北省中医药管理局科研计划项目(2020055)。
关键词
健脾温肾活血方
糖尿病肾脏疾病
脾肾阳虚兼血瘀型
白细胞介素-6
肿瘤坏死因子-α
decoction for fortifying spleen,warming kidney and activating blood
diabetic kidney disease
syndrome of spleen-kidney Yang deficiency with blood stasis
interleukin-6
tumor necrosis factor-α
