益气养阴活血祛风法治疗糖尿病肾病Ⅲ期气阴两虚兼瘀证患者临床研究  

Clinical study on “Yiqi Yangyin Huoxue Qufeng Therapy ”in treating diabetic nephropathy in stage Ⅲ with qi-yin deficiency and blood-stasis

作　　者：李珺[1] 王怡[2] 米秀华 

机构地区：[1]上海中医药大学研究生院,上海201203 [2]上海中医药大学附属岳阳中西医结合医院肾病科,上海200437 [3]上海市杨浦区中医医院,上海200090

出　　处：《上海中医药杂志》2016年第9期42-44,100,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市中医临床重点学科建设项目(zyxk2012004)

摘　　要：目的观察益气养阴活血祛风法治疗糖尿病肾病Ⅲ期的临床疗效。方法将60例气阴两虚兼瘀证糖尿病肾病Ⅲ期患者随机分为两组(各30例),均予合理饮食、控制血脂和血糖等处理;治疗组口服益气养阴活血祛风中药汤剂治疗,对照组口服科素亚治疗,疗程12周。观察两组临床疗效、中医证候积分、24 h尿微量白蛋白、尿ACR、Cysc、GFR、FPG、Hb A1c、TC、TG、TNF-α等指标变化。结果 1治疗组总有效率为86.67%,对照组为53.33%;治疗组临床疗效优于对照组(P<0.05);2治疗后,治疗组中医证候积分较治疗前显著降低(P<0.01),且低于对照组(P<0.01);3治疗后,两组Cysc、尿ACR、24 h尿微量白蛋白均较治疗前有所下降(P<0.05,P<0.01),且治疗组低于对照组(P<0.05,P<0.01);4治疗后,治疗组FPG、Hb A1c、TC、TG、TNF-α水平均较治疗前下降(P<0.05,P<0.01),且低于对照组(P<0.05,P<0.01)。结论益气养阴活血祛风法能减轻糖尿病肾病Ⅲ期患者的尿蛋白,降低TNF-α水平,改善糖脂代谢。Objective To observe the clinical efficacy of ＂Yiqi Yangyin Huoxue Qufeng Therapy＂ in the treatment of diabetic nephropathy in stage III with qi-yin deficiency and blood-stasis. Methods Sixty subjects were randomized into two groups （30 cases in each group）. All were received conventional modalities and controlled the blood lipid and glucose. The treatment group was given ＂Yiqi Yangyin Huoxue Qufeng＂ decoction and the control group was given losartan, with a course of 12 weeks. The clinical efficacy, syndrome score of Traditional Chinese Medicine （TCM）, urinary albumin within 24 hours, urine ACR, Cysc, GFR, FPG, HbAl C, TC, TG and TNF-α were observed and compared. Results ①The total effective rate was 86.67% in the treatment group and 53.33% in the control group, and the efficacy in the treatment group was better than that in the control group （ P 〈 0.05 ） ; ②After treatment, the syndrome score of TCM in the treatment group significantly decreased compared with before treatment（ P 〈 0.01 ）, and was lower than that in the control group（ P 〈 0.01 ） ;③After treatment the levels of Cysc, urine ACR and urine albumin within 24 h all decreased in both groups compared with before treatment（P 〈0.05 ,P 〈0.01 ）, and those in th, treatment group were lower than those in the control group （ P 〈 0.05, P 〈 0.01 ） ; ④After treatment, the levels of FPG, HbAI c, TC, TG and TNF-α in the treatment group decreased compared with before treatment （ P 〈 0.05, P 〈 0.01 ）, and was lower than those in the control group （ P 〈 0.05, P 〈 0.01 ）. Conclusion ＂Yiqi Yangyin Huoxue Qufeng Therapy＂ can reduce the level of the urine protein and TNF-α, and improve the metabolism of glucose and lipid in the patients with diabetic nephropathy in stage III.

关 键 词：糖尿病肾病 益气养阴活血祛风法 中医药疗法 

分 类 号：R259[医药卫生—中西医结合]