益气通络法治疗早期糖尿病肾病30例  

Thirty Cases with Diabetic Nephropathy at the Early Stage Treated by the Method of Benefiting Qi and Dredging Collaterals

作　　者：许华[1] 路亮 XU Hua LU Liang(The ThiM Affiliated Hospital of Henan University of Chinese Medieine,Zhengzhou, Henan,China,450008 Zhengzhou Hospital of Chinese Medicine, Zhengzhou, Henan, China,450007)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]郑州市中医院,河南郑州450007

出　　处：《河南中医》2017年第7期1247-1249,共3页Henan Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(编号:2016ZY2100)

摘　　要：目的:观察益气通络法对气阴两虚、瘀血阻络型早期糖尿病肾病(diabetic nephropathy)患者的临床疗效。方法:将60例符合纳入标准的早期DN患者随机分为对照组和治疗组各30例。两组均予DM教育,运动、饮食控制方法治疗。对照组给予缬沙坦80 mg,每日1次。治疗组在对照组治疗的基础上加服益气通络方,每次煎煮取汁150 m L,日1剂,早晚2次饭前30 min温服。两组均治疗1月为1个疗程,共观察2个疗程。观察两组患者治疗前后临床症状改善情况和血脂、24 h尿蛋白定量、转化生长因子-β1等理化检查指标的变化。结果:治疗组有效率为96.42%,对照组有效率为89.99%,两组有效率比较有显著性差异(P<0.05);两组患者治疗后血清转化生长因子-β1显著降低(P<0.05),且组间比较亦有统计学意义(P<0.05),治疗组优于对照组;两组患者治疗后血脂、24 h尿蛋白指标均较治疗前显著改善(P<0.05),且组间比较差异有统计学意义(P<0.05)。结论:益气通络法治疗早期DN,疗效显著,可明显改善患者临床症状,降低三酰甘油、低密度脂蛋白水平,提高高密度脂蛋白水平,减少尿白蛋白排出和降低血清转化生长因子-β1水平,其作用机制与改善糖脂代谢紊乱,抑制血清转化生长因子-β1过度表达有关。Objective：To observe the clinical effects of the method of benefiting qi and dredging collaterals on diabetic nephropathy （DN） of qi and yin deficiency syndrome and blood-stasis obstructing the collaterals at the early stage. M ethods：Totally 60 patients with DN at the early stage accorded with the criteria were included and randomized into control group and treatment group, 30 cases in each group. Both groups were given DM education and dietary and physical exercise control. Control group were given Valsartan of 80 mg, once a day, while treatment group were added with Qi-Benefiting and Collateral-Dredging Prescription, a dose of 150 mL solution a day taken 30 min before breakfast and supper respectively ,one month as a treatment course for both groups and two groups were observed for 2 treatment courses. The improvement of clinical symptoms and the changes of blood lipid, UPR of 24 h,TGF-βin both groups were observed. Results ：The effective rate was 96. 42% in treatment group and 89.99% in control group, with statistical significance （ P 〈 0.05）. The levels of TGF-βin both groups declined significantly （ P 〈 0.05 ）, and treatment group were superior to control group; indicators of blood lipid UPR of 24 h in both groups improved greatly compared those before treatment（P 〈0.05） ,and the difference between the two groups was significant （P 〈 0.05）. Conclusion： The method of benefiting qi and dredging collaterals has significant therapeutic effects on DN, which can obviously improve the clinical symptoms, decrease the levels and TG and LDL, enhance the HDL, reduce the urine protein elimination and the level of TGF-β. The mechanism is associated with the improvement of the glucose and lipid metabolism disorder,and inhibition of the over-expression of TGF-β.

关 键 词：早期糖尿病肾病 益气通络法 缬沙坦 

分 类 号：R259.872[医药卫生—中西医结合]