益气养阴通络汤治疗糖尿病肾病G3aA2期气阴两虚血瘀证的临床疗效与安全性评价  

Clinical efficacy and safety evaluation of treating diabetic kidney disease with deficiency of both qi and yin and blood stasis syndrome in G3aA2 stage by Yiqi Yangyin Tongluo Decoction

作　　者：刘迎迎[1,2] 郭兆安[2] 周太荣[2] 张磊[2] 房婧[3] 张思超[4] LIU Ying-ying;GUO Zhao-an;ZHOU Tai-rong;ZHANG Lei;FANG Jing;ZHANG Si-chao(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Afiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250012,China)

机构地区：[1]山东中医药大学,济南250355 [2]山东中医药大学附属医院,济南250014 [3]山东中医药大学第二附属医院,济南250012 [4]山东中医药大学中医学院,济南250355

出　　处：《中华中医药杂志》2021年第2期1180-1184,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：山东省保健科技协会科学技术课题(No.SDBJKT20180114);山东省中医药科技发展计划项目(No.2017-055,No.2017-048);国家自然科学基金面上项目(No.81874440,No.81974561);山东省自然科学基金博士基金(No.ZR2017BH091);中国博士后基金面上项目(No.2017M612342);齐鲁卫生与健康杰出青年人才工程专项。

摘　　要：目的:观察益气养阴通络汤干预糖尿病肾病(DKD)G3aA2期气阴两虚血瘀证的临床疗效及安全性。方法:选取符合纳入标准的患者68例,采用随机对照试验研究方法分为试验组和对照组,每组34例,试验组在常规治疗基础上加用益气养阴通络汤,对照组在常规治疗基础上联合缬沙坦胶囊口服;观察两组患者治疗前后血生化指标、肾小球及足细胞损伤指标的变化趋势,综合评价益气养阴通络法干预DKD G3aA2期气阴两虚血瘀证的临床疗效。结果:与治疗前比较,两组患者治疗后的UACR、UPCX/UCR、UNephrin/UCR、TC、TG、FBG、HbAlc、SCr、BUN、Cys C、β2-MG、Hcy显著下降(P<0.01,P<0.05),且试验组UACR、UPCX/UCR、TC、TG、HbAlc、SCr、Cys C水平显著低于对照组同期(P<0.01)。试验组患者治疗前后的血常规、电解质、肝功能等指标无异常变化。结论:益气养阴通络汤不仅能够显著降低DKD G3aA2期气阴两虚血瘀证患者的肾小球足细胞损伤程度,而且能够显著降低血脂、血糖、肾功能等生化指标的水平;同时安全性良好。Objective:To observe the clinical efficacy and safety of Yiqi Yangyin Tongluo Decoction in the intervention of diabetic nephropathy with G3 aA2 syndrome of qi and Yin deficiency and blood stasis.Methods:A total of 68 patients who met the inclusion criteria were selected and divided into experimental group and control group(34 cases in each group)by randomized controlled trial method.The experimental group was added with Yiqi Yangyin Tongluo Decoction on the basis of conventional treatment,while the control group was combined with valsartan capsule for oral administration on the basis of conventional treatment.To observe the change trend of blood biochemical indexes,glomerular and podocyte indexes before and after treatment in the two groups of patients,and to comprehensively evaluate the clinical efficacy of the method of nourishing qi nourishing yin and activating collaterals in the intervention of the syndrome of qi yin deficiency and blood stasis syndrome in DKD G3 aA2.Results:Compared with before treatment,UACR,UPCX/UCR,UNephrin/UCR,TC,TG,FBG,HbAlc,SCr,BUN,Cys C,β2-MG,Hcy and other indicators were all significantly decreased with statistically significant differences(P<0.01,P<0.05).After treatment,UACR,UPCX/UCR,TC,TG,HbAlc,SCr and Cys C levels in the experimental group all showed a significant downward trend,with statistical differences(P<0.01).There were no abnormal changes in blood routine,electrolyte and liver function in the experimental group before and after treatment.Conclusion:It can not only significantly reduce the degree of glomerular podocytosis in patients with DKD G3 aA2 deficiency and blood stasis syndrome,but also significantly reduce the level of blood lipid,blood glucose,renal function and other biochemical indicators in the above patients.At the same time,the safety is good.

关 键 词：益气养阴通络汤 糖尿病肾病 气阴两虚证 临床疗效 安全性评价 

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