益肾泄浊法内服外敷一体化治疗糖尿病肾病中晚期肾功能不全的临床研究  

Clinical Research on Effects of Yishen Xiezuo Method for Diabetic Nephropathy of Renal Dysfunction at Middle-late Stage with Internal and External Treatment

作　　者：胡静[1] 郁东海[1] 路建饶[1] 王晓东[1] 陈秀峰[1] 陈杰[1] 

机构地区：[1]上海中医药大学附属第七人民医院肾病科,上海200001

出　　处：《辽宁中医杂志》2017年第4期775-779,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：浦东新区科技发展基金创新基金项目(PKJ2013-Y23);上海市卫计委科研基金(2014LP032A);上海市科委科研基金(15401930600)

摘　　要：目的:通过前瞻性随机对照临床研究,探讨益肾泄浊法内服外敷一体化法治疗糖尿病肾病中晚期肾功能不全、延缓肾功能衰竭的临床疗效及可能的作用机制。方法:纳入病情稳定的糖尿病肾病Ⅲ-Ⅳ期患者108例,随机分组:西药对照组、中西药治疗组和中西药加脐疗内服外敷一体化治疗组,观察3组患者治疗前后临床症状体征变化、常规实验室检查项及炎性细胞因子(TGF-β1、MCP-1和TNF-α)等指标的变化。结果:(1)3组分别治疗后,患者的中医证候积分均显著降低且以中西药加脐疗内服外敷一体化治疗组的变化水平及证候总有效率最高(P<0.05)。(2)患者经中西药加脐疗内服外敷一体化治疗后,血脂、血白蛋白含量得到显著升高(P<0.05),尿蛋白含量及肾功能生化指标-BUN的含量得到持续性显著降低(P<0.05)。(3)经中西药加脐疗内服外敷一体化治疗后,患者的肾损伤炎性细胞因子得到了有效控制(P<0.05)。结论:益肾泄浊法内服外敷一体化治疗能够有效作用于糖尿病肾病早期肾功能不全并延缓肾功能衰竭。Objective ： To investigate the intervention effects and the possible mechanism of Yishen Xiezuo Formula with internal and external treatment for middle - late diabetic nephropathy patients of renal insufficiency and renal failure by the prospective randomized controlled clinical study. Methods ： A total of 108 cases of patients with a stable condition of diabetic nephropathy m 1V period were in this study. Random grouping：the control group, the Chinese and western medicine treatment group, the Chinese and western medicine treatment group with umbilical therapy internal and external integration. Observe the patients in three groups,including clinical symptoms and signs, conventional laboratory tests and inflammatory cytokines （TGF- β1 ,TNF- α, MCP - 1 ）. Results ： （ 1 ） After treatment, TCM clinical symptoms were significantly lower for all patients, and the group named Chi- nese and western medicine with umbilical therapy treatment had a highest total effective rate （ P 〈 O. 05 ）. （2） By the Chinese and western medicine with umbilical therapy treatment in patients, the contents of blood lipids, blood albumin were significantly in- creased （ P 〈 O. 05 ）. Compared the control group with valsartan alone, the urinary protein, renal function and biochemical index, the content of BUN was significantly reduced （ P 〈 0. 05）. （3） After the method of internal and external integration treatment,in- flammatory cytokines in patients with renal injury has been effectively controlled. Conclusion ： Yishen Xiezuo Formula with internal and external treatment can effectively contribute for the middle - late diabetic nephropatby patients with renal insufficiency and can delay the renal failure.

关 键 词：益肾泄浊法 糖尿病肾病 炎性细胞因子 

分 类 号：R587.2[医药卫生—内分泌]