益气养阴消癥通络中药治疗Ⅳ期糖尿病肾病的临床研究  

Clinical efficacy of Yiqi Yangyin xiaozheng Tongluo Fang on patients with stage Ⅳ diabetic nephropathy

作　　者：郭倩[1] 陈志强[2] 方敬[1] 白璐[1] 王月华[3] 郭登洲[2] 王元松[4] 周潮 张江华[1] 

机构地区：[1]河北医科大学,河北050017 [2]河北省中医院 [3]河北医科大学第三医院 [4]河北省沧州中西医结合医院 [5]河北省秦皇岛市中医院

出　　处：《北京中医药大学学报》2016年第9期779-782,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：河北省科技支撑计划资助项目(No.09276101D-27)

摘　　要：目的探讨益气养阴消癥通络中药对IV期糖尿病肾病的治疗作用。方法将符合纳入标准的160例IV期糖尿病肾病患者随机分为中药组81例和对照组79例,在基础治疗相同的情况下,中药组加益气养阴消癥通络中药治疗,对照组加厄贝沙坦治疗,总观察期为6个月。治疗前后分别观察2组患者终点事件发生率,症状改善情况,并检测尿微量白蛋白排泄率(m Alb)、24 h尿蛋白定量(U-pro/24 h)、血肌酐(Scr)、尿素氮(BUN)、空腹血糖(FPG)、糖化血红蛋白(Hb Alc)、胆固醇(TC)、甘油三酯(TG)等指标。结果中药组在随访过程中未出现进展至V期糖尿病肾病患者,对照组有2例治疗后血肌酐>133μmol/L,但2组比较差异无统计学意义(P>0.05)。中药组患者乏力、口干、腰痛、水肿症状缓解有效率显著高于对照组(P<0.01)。与治疗前相比,2组m Alb、Upro/24 h均明显降低(P<0.01)。与对照组治疗后相比,中药组治疗后m Alb、U-pro/24 h降低更为显著(P<0.05),并能降低甘油三酯水平(P<0.05)。结论益气养阴消癥通络中药对IV期糖尿病肾病蛋白尿具有确切的治疗作用,并能降低甘油三酯水平,纠正脂代谢紊乱,且能改善糖尿病肾病患者症状,提高患者生存质量。Objective To investigate the clinical efficacy of Yiqi Yangyin xiaozheng Tongluo Fang（ YYXTF）,a Chinese medicine compounds formulated by the principle of replenishing qi,nourishing yin,eliminating abdominal masses,and freeing the collateral vessels,on patients with stage IV diabetic nephropathy（ DN）. Methods A total of 160 patients with stage IV diabetic nephropathy according to inclusion criteria were randomly divided into traditional Chinese medicine group（ TCM group,n = 81）and control group（ n = 79）. In addition to general treatment,patients in TCM group took orally YYHXF and those in control group took irbesartan for consecutive six months. The incidence of end point events,improvement of clinical symptoms and urine micro-albumin excretion rate（ m Alb）,24 hours urine total protein（ U-pro /24 h）,serum creatinine（ Scr）,blood urea nitrogen（ BUN）,fasting plasma glucose（ FPG）,glycosylated hemoglobin（ Hb Alc）,total cholesterol（ TC） and triglycerides（ TG） were recorded before and after treatment. Results During the follow-up period,compared with control group whose two patients with Scr 〉133 μmol / L,TCM group without patients progressing to stage V showed no statistical significance（ P〉0. 05）. Efficacy rate of relieving symptoms of hypodynamia,mouth dryness,back pain,edema in TCM group were significantly higher than that of control group（ P〈0. 01）. Intragroup comparison showed that m Alb and U-pro /24 h decreased after treatment（ P〈0. 01）. After treatment,m Alb and U-pro /24 h of TCM group were significantly lower than that of control group（ P〈0. 05）,and the level of TG of TCM group also decreased（ P〈0. 05）. Conclusion Yiqi Yangyin Huayu Tongluo Fang showed definite therapeutic effect on stage IV diabetic nephropathy proteinuria. It could reduce TG levels and protected against dyslipidemia. In addition,it relieved the symptoms and improved the quality of patients＇ life.

关 键 词：益气养阴消癥通络中药 糖尿病肾病 临床研究 厄贝沙坦 

分 类 号：R225.4[医药卫生—中医基础理论]