参芪地黄汤化裁方治疗早期糖尿病肾脏病临床观察  

Clinical observation of modified Shenqi Dihuang Decoction in treating early stage of diabetic kidney disease

作　　者：吕翠岩[1] 贾晓蕾 张岩[3] 郑爽 王晖[1] 李倩[1] 刘铜华[5] LV Cui-yan;JIA Xiao-lei;ZHANG Yan;ZHENG SHUANG;WANG Hui;LI Qian;LIU Tong-hua(Department of TCM Nephrology,Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University,Beijing 100010,China;The Third Hospital Affiliated to the Beijing University of Chinese Medicine,Beijing 100029;Department Traditional Chinese Medicine,Beijing Friendship Hospital Affiliated to the Capital Medical University,Beijing 100050;College of Clinical Medicine,Beijing University of Chinese Medicine,Beijing 100029;Beijing University of Chinese Medicine,Beijing 100029)

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]北京中医药大学第三附属医院,北京100029 [3]首都医科大学附属北京友谊医院中医科,北京100050 [4]北京中医药大学临床医学院,北京100029 [5]北京中医药大学,北京100029

出　　处：《北京中医药》2020年第4期306-310,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：国家重大新药创制项目(2012ZX09102201-001);教育部博士点基金立项课题(20110013130001);北京中医药大学创新团队项目(2011-CXTD-19);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治疗早期糖尿病肾脏疾病(diabetic kidney disease,DKD)的临床疗效并评价其安全性。方法回顾性纳入气阴亏虚、脉络瘀阻证的早期糖尿病肾病患者66例,治疗组及对照组各33例,对照组给予常规的糖尿病肾病基础治疗,治疗组在对照组基础上给予参芪地黄汤化裁方口服,连续给药12周,观察2组的临床疗效、中医证候积分、空腹血糖(FPG)、餐后2 h血糖(2 hPBG)水平、糖化血红蛋白(HbA1c)、血压、血脂(TC、TG)、尿素氮(BUN)、血肌酐(Scr)、尿白蛋白肌酐比值(UACR)、同型半胱氨酸(HCY)及超氧化物歧化酶(SOD)改变。结果治疗后,治疗组患者临床疗效、中医证候总积分、血糖、血脂、血压、SOD均较治疗前有显著改善(P<0.05,P<0.01);治疗组中医证候总积分、2 h PBG、HbA1c、UACR优于对照组,差异有统计学意义(P<0.05,P<0.01)。结论参芪地黄汤化裁方联合基础治疗能够改善气阴亏虚、脉络瘀阻证早期DKD患者的临床症状,控制肾脏疾病进展,为中医药治疗早期糖尿病肾病提供新思路。Objective To observe the clinical efficacy of modified Shenqi Dihuang Decoction in treating early stage of diabetic kidney disease(DKD).Methods 66 cases of early DKD patients with deficiency of Qi and Yin and obstruction of collaterals were retrospectively enrolled of 33 cases in each group.The control group was given the basic treatment for diabetic nephropathy.The treatment group was given Shenqi Dihuang Decoction Granules on the basis of the control group.The clinical efficacy,TCM syndrome score,fasting blood sugar(FPG),2 h postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1 c),blood pressure,urea nitrogen(BUN),serum creatinine(Scr),urinary albumin creatinine ratio(UACR),homocysteine(HCY)and superoxide dismutase(SOD)changes of the two groups were observed after 12 weeks of treatment.Results After treatment,the clinical effect,blood glucose,blood lipid,blood pressure,and SOD in the treatment group was significantly improved compared with that before treatment,TCM syndrome score,2 hPBG,HbA1 c and UACR of the treatment groups were better than those of the control group with the difference statistically significant.Conclusion The combined treatment of modified Shenqi Dihuang Decoction with basic treatment can improve the clinical symptoms of early DKD patients with deficiency of Qi and Yin and obstruction of collaterals and control the progress of kidney disease,and it can provide new ideas for the treatment of early DKD with traditional Chinese medicine.

关 键 词：参芪地黄汤化裁方 糖尿病肾脏病 尿蛋白 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]