参芪地黄汤化裁方对Ⅲ期糖尿病肾病尿蛋白及临床进展的影响  

Effect of Shenqi Dihuang Decoction on Urinary Protein and Clinical Progress in Stage Ⅲ Diabetic Nephropathy

作　　者：吕翠岩[1] 贾晓蕾 郑爽 李倩[1] 刘铜华[3] LYU Cuiyan;JIAXiaolei;ZHENG Shuang;LI Qian;LIU Tonghua(Department Nephrology,Capital Medical University Affiliated to Beijing Hospital of Traditional Chinese Medicine,Beijing 100010,China;Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京中医医院肾内科,北京100010 [2]北京中医药大学附属第三医院,北京100029 [3]北京中医药大学,北京100029

出　　处：《吉林中医药》2020年第4期480-484,共5页Jilin Journal of Chinese Medicine

基　　金：国家重大新药创制项目(2012ZX09102201-001);教育部中医养生学重点实验室资助;北京市中医养生学重点实验室资助;首都医科大学科研培育基金(校基金)(PYZ2017140);北京市属医院科研培育计划项目(PZ2017017)。

摘　　要：目的观察参芪地黄汤化裁方对Ⅲ期糖尿病肾病患者尿微量白蛋白尿/肌酐比值、24 h尿蛋白定量等指标及其对疾病进展的影响。方法回顾性纳入73例气阴两虚夹瘀型Ⅲ期糖尿病肾病患者,根据当时用药情况分为对照组35例,给予常规西医治疗,治疗组38例,在西医治疗基础上联合参芪地黄汤化裁方,治疗12个月后,比较2组临床治疗效果,观察2组中医证候积分变化,并测定临床指标以及进入MogensenⅣ期病例数。结果治疗12个月后,治疗组临床疗效总有效率为86.8%,优于对照组的65.7%(P<0.05);与治疗前比较,治疗后2组血糖、血脂、UA、HCY及SOD较治疗前均有不同程度的改善(P<0.05或P<0.01),部分治疗组优于对照组,差异有统计学意义(P<0.05或P<0.01);治疗组治疗后UACR及UTP较治疗前降低,且组间比较,差异有统计学意义(P<0.01或P<0.05),治疗组2例患者(5.2%)进入糖尿病肾病IV期,与对照组8例(22.9%)比较,差异有统计学意义(P<0.05)。结论参芪地黄汤化裁方能有效改善Ⅲ期糖尿病肾病气阴两虚夹瘀型患者症状积分、降低其UACR、UTP、HCY水平及升高SOD的含量,保护肾脏,延缓疾病进一步进展。Objective To observe the effect of Shenqi Dihuang decoction on urinary microalbuminuria creatinine ratio and 24-hour urinary protein in patients with stage Ⅲ diabetic nephropathy and its influence on disease progression.Methods 73 patients of stage Ⅲ diabetic nephropathy with deficiency of both qi and yin and blood stasis were retrospectively enrolled.The control group (n=35) was given basic treatment of diabetic nephropathy.The treatment group (n=38) was given Shenqi Dihuang decoction orally on the basis of the control group.After 12 months of treatment,the clinical effect of the two groups was compared,and the changes of TCM syndrome score in the two groups were observed,and the clinical indexes and the number of cases entering theMogensen Ⅳ stage were measured.Results After one-year treatment,the total effective rate of the treatment group was 86.8%,which was better than 65.7% of the control group (P<0.05).Compared with before,the blood glucose,blood lipid,UA,HCY,SOD,UACR and 24-hour UTP in the two groups were signifi cantly improved after treatment (P<0.05 or P<0.01),and some index of the treatment groups were better than those in the control group (P<0.05 or P<0.01).Two patients (5.2%) in the treatment group entered IV stage,which was signifi cantly better than 8 patients (22.9%) in the control group.Conclusion Shenqi Dihuang decoction can effectively improve the symptom score,reduce UACR,UTP,HCY and SOD in patients with stage Ⅲ diabetic nephropathy with deficiency of both qi and yin,protect the kidney and delay the progression of the disease.

关 键 词：Ⅲ期糖尿病肾病 糖尿病 气阴两虚夹瘀型 参芪地黄汤 

分 类 号：R255.4[医药卫生—中医内科学]