中药黄龙颗粒治疗Ⅲ、Ⅳ期糖尿病肾病水肿的临床疗效及对身体成分影响的研究  

Clinical Efficacy of Huanglong Granules for Treating Edema in Patients with Phase Ⅲ,Ⅳ Diabetic Nephropathy and Influence of Body Compositions

作　　者：曾又佳[1] 徐缘钊 邓茜[1] 李芸[1] ZENG You-Jia;XU Yuan-Zhao;DENG Qian;LI Yun(Dept.of Nephrology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]深圳市中医院肾病科,广东深圳518033

出　　处：《广州中医药大学学报》2020年第3期404-408,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市科创委科研课题(编号:JCYJ20150401163247238);深圳市医疗卫生三名工程项目——天津市中医药研究院张大宁国医大师中医药防护肾脏疾病团队项目(编号:SZSM201512040)。

摘　　要：【目的】探讨益气活血通络类药物黄龙颗粒治疗Ⅲ、Ⅳ期糖尿病肾病(DN)水肿的临床疗效及对身体成分的影响。【方法】将45例气虚血瘀型Ⅲ期、Ⅳ期DN水肿患者随机分为治疗组22例和安慰剂组23例。2组患者均在原有降糖方案基础上给予服用缬沙坦胶囊治疗,与此同时,治疗组给予黄龙颗粒治疗,安慰剂组给予安慰剂颗粒治疗,疗程为6个月。观察2组患者治疗前后中医证候积分、血尿生化指标[血红蛋白(Hb)、血肌酐(Cr)、尿素氮(BUN)、血尿酸(UA)、血白蛋白(ALB)、24h尿蛋白(24hUPG)和尿蛋白肌酐比(UACR)等]及部分生物电阻抗(BIA)指标[身体总水分、身体细胞量和全身相位角]变化情况。【结果】(1)治疗后,治疗组患者的证候积分较治疗前明显降低(P<0.05),而安慰剂组无明显降低(P>0.05),治疗组患者对证候积分的降低作用明显优于安慰剂组,组间差值比较,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的Cr、24hUPG、UACR等肾功能指标均较治疗前有一定程度升高,其中安慰剂组与治疗前比较,差异均有统计学意义(P<0.05),而治疗组的升高幅度均未达统计学差异(P>0.05);治疗组患者Cr、24hUPG、UACR水平的升高幅度均略低于安慰剂组,组间差值比较,差异均有统计学意义(P<0.05)。(3)治疗后,安慰剂组患者的各项BIA指标均无明显变化(P>0.05),而治疗组患者的身体总水分有所减少,全身相位角有所增加,但与治疗前比较,差异均无统计学意义(P>0.05);治疗组患者的身体总水分减少幅度及全身相位角增加幅度均明显高于安慰剂组,组间差值比较,差异均有统计学意义(P<0.05)。【结论】中药黄龙颗粒能够显著改善Ⅲ、Ⅳ期DN患者气虚血瘀证候,改善患者水肿及细胞营养状况,并能稳定蛋白尿进展,但对肾功能的进展改善不明显。Objective To explore the therapeutic effect of Huanglong Granules with the actions of replenishing qi,activating blood,and unblocking collaterals for the treatment of edema in patients with phase Ⅲ,Ⅳ diabetic nephropathy(DN),and to investigate the influence of the granules on the body compositions. Methods A total of45 edema patients with phase Ⅲ,Ⅳ diabetic nephropathy and differentiated as qi deficiency and blood stasis syndrome were randomized into treatment group(22 cases)and control group(23 cases). Both groups were given basic regimen for lowering blood glucose together with oral use of valsartan capsules, and additionally, the treatment group was given oral use of Huanglong Granules and control group was given placebo granules. The treatment for the two groups lasted 6 months. Before and after treatment,we observed the changes in the scores of traditional Chinese medicine syndrome, the blood and urine biochemical indexes such as hemoglobin(Hb),creatinine(Cr),blood urea nitrogen(BUN),urine acid(UA),blood albumin(ALB),24-hour urinary protein(24 hUPG), and urinary albumin-to-creatinine ratio(UACR), and partial bioelectrical impedance indicators such as total body water,body cell amount,and body phase angle. Results(1)After treatment,the scores of traditional Chinese medicine syndrome in the treatment group were much decreased in comparison with those before treatment(P<0.05),while no obvious changes were shown in the control group(P>0.05). The treatment group had stronger effect on decreasing the scores than the control group, and there was significant difference in the difference values of the scores between the two groups(P<0.05).(2)The renal function indicators such as Cr,24 hUPG,and UACR in the two groups were increased to some extent after treatment,and the increase in the control group was significant in comparison with that before treatment(P<0.05)while in the treatment group was insignificant(P>0.05). The ascending range of Cr,24 hUPG,and UACR in the treatment group was mildly lower than that i

关 键 词：益气活血通络药 黄龙颗粒 糖尿病肾病 水肿 气虚血瘀 生物电阻抗 

分 类 号：R259.872[医药卫生—中西医结合]