化湿泻浊方辨证加减治疗糖尿病肾病(DKD)上焦湿热证的效果及对炎症反应的影响  

Effect of dialectical addition and subtraction of Huashi Xiezhuo Recipe on damp heat syndrome of upper energizer in diabetes nephropathy(DKD)and its influence on inflammatory reaction

作　　者：赵慧芳 傅文[2] 马梦圆 杜雨晨 杨巧菊[1] 徐慧 ZHAO Huifang;FU Wen;MA Mengyuan(School of Nursing,Henan University of Chinese Medicine,Zhengzho Henan 453000,China;Department of Rheumatology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 453000,China)

机构地区：[1]河南中医药大学护理学院,河南郑州453000 [2]河南中医药大学第一附属医院风湿科,河南郑州453000

出　　处：《四川中医》2023年第10期136-140,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河南省健康委员会,河南省中医药科学研究专项课题(编号:2021ZY2026)

摘　　要：目的:研究化湿泻浊方辨证加减治疗糖尿病肾病(DKD)上焦湿热证的效果及对炎症反应的影响。方法:选取2021年10月至2022年10月我院94例DKD患者为样本,采用随机数字表法均分为观察组和对照组各47例进行前瞻性对照研究,两组均根据指南给予个体化降糖、降压和降血脂等基础治疗,观察组另加用化湿泻浊方加减进行治疗,4周为1个疗程,共3个疗程,比较两组临床疗效、中医证候积分、血糖、肾功能以及炎症因子等指标。结果:观察组和对照组治疗3个疗程时有效率分别为89.36%和72.34%(P<0.05);两组治疗后上焦湿热证主症和次症评分均显著降低(P<0.05),且观察组评分低于对照组,差异有统计学意义(P<0.05);两组治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)和糖化血红蛋白(HbA1c)显著降低(P<0.05),且观察组FPG和HbA1c低于对照组,差异有统计学意义(P<0.05);两组治疗后尿蛋白排泄率(UAER)、血肌酐(Scr)和尿素氮(BUN)显著降低(P<0.05),且观察组UAER、Scr和BUN低于对照组,差异有统计学意义(P<0.05);两组治疗后血清白介素~6(IL-6)、肿瘤坏死因子α(TNF-α)及C反应蛋白(CRP)水平显著降低(P<0.05),且观察组血清IL-6、TNF-α和CRP低于对照组,差异具有统计学意义(P<0.05)。结论:化湿泻浊方辨证加减治疗DKD上焦湿热证有利于减轻炎症反应,改善糖代谢和肾功能,对提升疗效具有积极作用。ObjectiveTo study the effect of dialectical addition and subtraction of Huashi Xiuzhuo decoction in the treatment of upper energizer dampness-heat syndrome of diabetic kidney disease(DKD)and its influence on inflammatory response.Methods 94 patients with DKD in the hospital from October 2021 to October 2022 were selected as the samples,and were divided into observation group and control group with 47 cases in each group by the random number table method for prospective control study.Both groups were given individualized hypoglycemic,hypohypertensive,hypolipidemic and other basic treatments according to the guidelines,and the observation group was additionally treated with addition and subtraction of Huashi Xiuzhuo decoction.Both groups were treated for 3 courses by taking 4 weeks as 1 course of treatment.The clinical efficacy,TCM syndromes scores,blood glucose,renal function and inflammatory factors were compared between both groups.Results The effective rates in observation group and control group at 3 courses of treatment were 89.36%and 72.34%(P<0.05).After treatment,the scores of primary and secondary symptoms of upper energizer dampness-heat syndrome in both groups were significantly decreased(P<0.05),and the scores were lower in observation group than those in control group(P<0.05).Fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG)and glycosylated hemoglobin(HbA1c)were significantly reduced in the two groups after treatment(P<0.05),and the levels of FPG and HbA1c in observation group were lower than those in control group(P<0.05).Urinary albumin excretion rate(UAER),serum creatinine(Scr)and blood urea nitrogen(BUN)were significantly decreased in two groups after treatment(P<0.05),and UAER,Scr and BUN were lower in observation group than those in control group(P<0.05).After treatment,serum levels of interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and C-reactive protein(CRP)in the two groups were significantly declined(P<0.05),and serum levels in observation group were lower than those in co

关 键 词：糖尿病肾病 上焦湿热证 化湿泻浊方 肾功能 炎症因子 

分 类 号：R587.2[医药卫生—内分泌]