益阴降糖1号方治疗气阴两虚、瘀血内阻型糖尿病肾病临床研究  

Clinical Research on No.1 Jiangtang Prescription in Treatment of Diabetic Nephropathy with Qi and Yin Deficiency and Blood Stasis Stagnation Syndrome

作　　者：李玉平[1] 刘佰洁 陈洪学 LI Yuping LIU Baijie CHEN Hongxue(TCM Hospital of Rizhao City, Rizhao Shandong China 276800 Rizhao Port Hospital, Rizhao Shandong China 276800 Lanshan District Maternal and Child Health Hospital of Rizhao City, Rizhao Shandong China 276807)

机构地区：[1]日照市中医医院,山东日照276800 [2]日照港口医院,山东日照276800 [3]日照市岚山区妇幼保健院,山东日照276807

出　　处：《中医学报》2017年第9期1625-1629,共5页Acta Chinese Medicine

摘　　要：目的:观察自拟益阴降糖1号方辨治气阴两虚、瘀血内阻型糖尿病肾病的临床疗效。方法:106例气阴两虚、瘀血内阻型糖尿病肾病患者按照随机数字表法分为对照组和观察组各53例。对照组患者给予厄贝沙坦片口服,观察组患者给予自拟益阴降糖1号方,15 d为1个疗程,两组均连续治疗4个疗程。比较两组患者临床疗效,检测治疗前后糖脂代谢、血液流变、肾功能指标,监测治疗前后患者血清γ-谷氨酰转肽酶(gamma glutamyl transpeptidase,GGT)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、缺氧诱导因子-1α(hypoxia-induced factor-1α,HIF-1α)水平。结果:观察组有效率为94.3%,对照组有效率为79.2%,两组比较,差异有统计学意义(χ2=5.267,P<0.05)。治疗后,观察组患者糖脂代谢、血液流变、肾功能指标与对照组比较,差异均有统计学意义(P<0.05)。治疗后,观察组患者GGT、VEGF、HIF-1α水平分别为(24.60±17.42)IU·L^(-1)、(126.45±23.74)ng·L^(-1)、(135.35±13.17)pg·L^(-1),对照组分别为(31.26±19.33)IU·L^(-1)、(182.34±25.15)ng·L^(-1)、(187.62±16.32)pg·L^(-1),两组比较,差异有统计学意义(P<0.05)。治疗后,观察组肾功能各指标均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血液流变学各指标均低于对照组,差异有统计学意义(P<0.05)。结论:自拟益阴降糖1号方辨治气阴两虚、瘀血内阻型糖尿病肾病疗效满意,可显著降低患者血糖水平,调节脂质代谢,改善肾功能,其机制可能为调节血液流变学指标及GGT、VEGF、HIF-1α水平以改善肾脏微循环、调节内皮功能、减轻氧化应激损伤、降低炎性反应。Objective： To observe the clinical curative effect of No. 1 Yiyin Jiangtang Prescription on diabetic nephropathy with Qi and Yin Deficiency and Blood Stasis Stagnation Syndrome. Methods： 106 cases of diabetic nephropathy patients with Qi and Yin Deficiency and Blood Stasis Stagnation Syndrome were randomly divided into control group and observation group,with 53 cases in each group. The patients in the control group were administered with Irbesartan tablets orally. The patients in the observation group were treated with No. 1Yiy Jiangtang Prescription. One course lasted 15 days. The two groups were treated continuously for 4 courses. The clinical efficacy of both groups were examined and compared. The levels of glucose and lipid metabolism,blood rheology,renal function index serum γ-glutamyl transpeptidase（ GGT）,vascular endothelial growth factor（ VEGF） and hypoxia-inducedfactor-1α（ HIF-1α） of both groups were measured before and after treatment. Results： The effective rate in the observation group was 94. 3% and that in the control group was 79. 2%. The difference was statistically significant（ χ2= 5. 267,P〈0. 05）. After treatment,the levels of glucose and lipid metabolism,blood rheology and renal function in the observation group were significantly different from those in the control group（ P〈0. 05）. After treatment,the levels of GGT,VEGF and HIF-1α in the observation group were（ 24. 60 ± 17. 42） IU·L^（-1） ,（ 126. 45 ± 23. 74） ng·L^（-1） ,（ 135. 35 ± 13. 17） pg·L（-1） respectively,while that of the control group were（ 18. 36 ± 19. 33） IU·L（-1） ,（ 182. 34 ± 25. 15） ng·L（-1） and（ 187. 62 ± 16. 32） pg·L（-1） respectively. The differences were statistically significant（ P〈0. 05）. After treatment,the indexes of the renal function of the observation group were significantly lower than those of the control group（ P〈0. 05）. After treatment,the indexes of hemorheology in the observation group were significantly lower

关 键 词：糖尿病肾病 气阴两虚、瘀血内阻证 益阴降糖1号方 肾功能 血液流变学 Γ-谷氨酰转肽酶 血管内皮生长因子 缺氧诱导因子-1α 中医疗法 

分 类 号：R259.872[医药卫生—中西医结合]