小陷胸汤合补阳还五汤治疗早期糖尿病肾病临床观察  

Clinical Observation of Xiaoxianxiong Tang Combined with Buyang Huanwu Tang in Treatment of Early Diabetic Nephropathy

作　　者：王涓涓[1,2] 邵岩 韩向莉 张艳 蔡井阳 常柏[3] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市滨海新区中医医院,天津300451 [3]天津医科大学代谢病医院,天津300020

出　　处：《中国实验方剂学杂志》2016年第21期152-156,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81273914)

摘　　要：目的:观察小陷胸汤合补阳还五汤治疗早期糖尿病肾病的临床疗效,并探讨其作用机制。方法:将86例患者随机分为治疗组和对照组,各43例,治疗组口服小陷胸汤合补阳还五汤,对照组口服替米沙坦40 mg/次,1次/d,两组疗程均为6个月。观察两组临床疗效、中医证候积分,并检测治疗前后尿白蛋白排泄率(UAER),血清肌酐(SCr),血尿素氮(BUN),空腹血糖(FBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白(LDL)及高密度脂蛋白(HDL)。结果:治疗组总有效率(87.8%)优于对照组(62.7%)(P<0.05);两组症状疗效改善率差异显著(P<0.05,P<0.01);治疗组治疗后UAER,SCr,BUN,FBG,TC,TG,LDL均明显低于治疗前(P<0.05,P<0.01),HDL较治疗前明显升高(P<0.05);治疗组治疗后与对照组比较,UAER,SCr,BUN,FBG有降低趋势;TC,TG,LDL降低,HDL升高(P<0.05)。结论:小陷胸汤合补阳还五汤结合西医基础治疗早期糖尿病肾病有较好的疗效。Objective： To observe the clinical efficacy of Xiaoxianxiong Tang combined with Buyang Huanwu Tang in treating early diabetic nephropathy. Method： Totally 86 patients were randomly divided into treatment group（ 43 cases,treated with Xiaoxianxiong Tang combined with Buyang Huanwu Tang） and control group（ 43 cases,treated with telmisartan,40 mg per day）. All patients were treated for 6 months. The changes in therapeutic efficacy, Chinese medicine syndrome scores, urinary albumin excretion rate（ UAER）, serum creatinine（ SCr）,blood urea nitrogen（ BUN）,fasting blood glucose（ FBG）,total cholesterol（ TC）,glycerol triester（ TG）,low-density lipoprotein（ LDL）,high-density lipoprotein（ HDL） were observed. Result： The total effective rate in treatment group was 87. 8%,which was obviously higher than that in control group（ 62. 7%）（ P〈0. 05）,with significant difference in efficacy improvement and symptom alleviation rates between the two groups（ P〈0. 05,P〈0. 01）. In treatment group,levels of UAER,SCr,BUN,FBG,TC,TG,LDL decreased significantly after treatment than before treatment（ P〈0. 05,P〈0. 01）,HDL increased significantly after treatment than before treatment（ P〈0. 05）. Compare with control group,levels of UAER,SCr,BUN,FBG decreased,and levels of TC,TG,LDL decreased,and levels of HDL increased（ P〈0. 05） after treatment in treatment group. The aforesaid indexes were also improved in the control group after treatment（ P〈0. 05,P〈0. 01）. Conclusion： Xiaoxianxiong Tang combined with Buyang Huanwu Tang show a better therapeutic efficacy on early diabetic nephropathy.

关 键 词：糖尿病肾病 小陷胸汤 补阳还五汤 中医证候积分 

分 类 号：R287[医药卫生—中药学]