滋水分清饮治疗糖尿病肾病及对血、尿β_2微球蛋白的影响  

Effect of Zishui Fenqing Decoction for diabetic nephropathy on serum and urinary beta 2-microglobulin

作　　者：莫伟[1] 周晖[1] 杨晓珍[1] 张芸[1] 龙文醒[1] 江丹[1] 李玉玲[1] 曹明满[1] 

机构地区：[1]广东省第二中医院内分泌科,广东广州510095

出　　处：《中国医药导报》2013年第22期121-123,共3页China Medical Herald

基　　金：广东省中医药局科研项目(编号2010266);广东省科技计划项目(编号2010B030700057)

摘　　要：目的观察滋水分清饮联合西药治疗早期糖尿病肾病的临床效果及其在糖尿病肾病各证型组的治疗规律。方法将符合入选标准的100例糖尿病肾病患者分为对照组34例、治疗组66例进行治疗观察,其中治疗组按中医证型进一步分为阴虚燥热、气阴两虚、脾肾气虚和阴阳两虚组进行观察。对照组在控制饮食、运动治疗基础上给予常规西药降糖、降压治疗;治疗组在对照组治疗基础上,服滋水分清饮;观察周期为3个月。观察中医症状积分、血β2微球蛋白及尿β2微球蛋白治疗前后差异,进行疗效评估。结果根据中医症状积分评估,治疗组总有效率为78.8%,对照组总有效率为50.0%,差异有统计学意义(P<0.05)。治疗后在治疗组中血β2微球蛋白、尿β2微球蛋白、血清肌酐均显著降低,分别为(2.14±1.59)mg/L、(0.36±0.56)mg/L、(73.80±47.89)μmol/L,与对照组比较,差异有统计学意义(P<0.05)。治疗组中4个证型分组治疗后,血β2微球蛋白在各组均有降低,阴虚燥热组差异有统计学意义(P<0.05),气阴两虚组、脾肾气虚组差异有高度统计学意义(P<0.01)。尿β2微球蛋白在阴虚燥热组、气阴两虚组、脾肾气虚组也显著降低(P<0.05)。结论滋水分清饮能显著改善早期糖尿病肾病患者的临床症状,降低早期肾损害血、尿β2微球蛋白等指标,对于气阴两虚、脾肾气虚患者效果比较显著。Objective To evaluate the effect of Zishui Fenqing Decoction in treating diabetic nephropathy,and the dif ference in the TCM syndromes.Methods 100 diabetic nephropathy patients were divided into control group（34 cases） and treatment group（66 cases）,and the treatment group was further divided into TCM syndromes types including Yin deficiency and heat extreme,Qi and Yin deficiency,spleen and kidney Qi deficiency and both Yin and Yang defi ciency.Control group was given the diet,exercise therapy and conventional western medicine such as hypoglycemic a gents,antihypertensive therapy;based on therapy in control group,treatment group was given Zishui Fenqing Decoc tion.The study period was 3 months.Scores of TCM,the serum beta 2-microglobulin and urinary beta2-microglobulin were observed before and after treatment,the efficacy statistical analysis was made.Results According to TCM symptom score,the total effective rate of treatment group was 78.8%,and control group was 50.0%（P 0.05）;after treatment,serum beta 2-microglobulin,urinary beta 2-microglobulin,serum creatinine in treatment group were significant ly reduced to（2.14±1.59） mg/L,（0.36±0.56） mg/L,（73.80 ±47.89） μmol/L respectively,compared with the control group（P 0.05）.In the 4 TCM syndromes subgroups of the treatment group after treatment,the level of serum beta 2microglobulin in all groups were lower,there was statistically significant difference in Yin deficiency and heat extreme（P 0.05）,and in Qi and Yin deficiency,spleen and kidney Qi deficiency（P 0.01）.The level of urinary beta 2-microglobulin were significantly reduced in Yin deficiency and heat extreme,Qi and Yin deficiency,spleen and kidney Qi deficiency（P 0.05）.Conclusion Zishui Fenqing Decoction can significantly improve the clinical symptoms of early diabetic nephropathy,reduce early renal damage according to blood,beta 2-microglobulin and urinary beta2-mi croglobulin,especially for the patients of Qi and Yin deficiency,spleen and kidney Qi deficiency.

关 键 词：糖尿病肾病 滋水分清饮 Β2微球蛋白 

分 类 号：R692.3[医药卫生—泌尿科学] R587.2[医药卫生—外科学]