黄连温胆汤联合贝那普利治疗湿热中阻型糖尿病肾病临床观察  

Clinical Observation Huanglian Wendan Decoction Combined with Benazepril in the Treatment of Diabetic Kidney Disease of Dampness-heat and Moderate-resistance Type

作　　者：施莹 赖龙胜 黄腾蛟 薛宇豪[3] SHI Ying;LAI Longsheng;HUANG Tengjiao;XUE Yuhao(Department of General Medicine,Jiangtou Street Community Health Service Center of Huli District,Fujian Province,Xiamen 350200,China;Department of Nephrology,Xiamen hospital,Beijing University of Chinese Medicine,Fujian Province,Xiamen 361000,China;School of Acupuncture and Moxibustion,Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou 350122,China)

机构地区：[1]厦门市湖里区江头街道社区卫生服务中心全科,福建厦门350200 [2]北京中医药大学厦门医院肾内科,福建厦门361000 [3]福建中医药大学针灸学院,福建福州350122

出　　处：《中国中医药现代远程教育》2021年第11期144-147,共4页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨加减黄连温胆汤联合贝那普利对湿热中阻型糖尿病肾病(Diabetic kidney disease,DKD)的临床疗效。方法本研究选取2016年10月1日—-2018年10月1日在厦门市中医院和厦门市湖里区江头街道社区卫生服务中心门诊及病房的84例DKD患者进行研究,按随机数字表法分为观察组和对照组,各42例。2组均采用饮食控制、降糖、降压、降脂等基础治疗,对照组单纯服用贝那普利10 mg/d,观察组在对照组的基础上,按照辨证施治,选择加减黄连温胆汤治疗。经30 d治疗后,比较2组治疗前后临床疗效、中医证候积分、肾小球滤过率(Estimated glomerular filtration rate,eGFR)、血肌酐(Serum creatinine,SCr)、尿素氮(Blood urea nitrogen,BUN)、空腹血糖(Fasting blood-glucose,FBG)、低密度脂蛋白(Low-density lipoprotein,LDL)情况。结果观察组总有效率88.10%(37/42)明显高于对照组总有效率66.67%(28/42),差异有统计学意义(P<0.05);2组治疗前中医证候积分差异无统计学意义(P>0.05),治疗后2组中医证候积分均优于治疗前,且治疗组优于对照组,差异均有统计学意义(P<0.05)。治疗前,2组eGFR、SCr、BUN、FBG、LDL指标比较差异无统计学意义(P>0.05);治疗后,2组各项指标均优于治疗前,且观察组治疗后SCr、BUN、FBG、LDL指标水平均较对照组治疗后指标显著降低(P<0.05),观察组治疗后eGFR指标水平均较对照组治疗后指标显著升高(P<0.05)。结论经临床对比,黄连温胆汤加减结合贝那普利治疗湿热中阻型DKD在降低中医证候积分、eGFR、SCr、BUN、FBG、LDL方面,优于单独使用贝那普利,值得临床推广。Objective To explore the clinical effect of Huanglian Wendan decoction combined with Benazepril on diabetic kidney disease(DKD)of dampness-heat and moderate-resistance type.Methods In this study,84 patients with DKD were enrolled in the outpatient department and ward of Xiamen Hospital of Traditional Chinese Medicine and Jiangtou Community Health Service Center of Huli District from October 1,2016 to October 1,2018.According to random number table method,they were divided into observation group and control group,with 42 cases in each group.The two groups were treated with diet control,hypoglycemic,hypotensive,lipid-lowering and other basic treatments.The control group was simply treated with 10 mg/d benazepril.The observation group was treated with Huanglian Wendan decoction based on syndrome differentiation.After 30 days of treatment,the clinical efficacy,traditional Chinese medicine(TCM)syndrome score,Estimated glomerular filtration rate(EGFR),Serum creatinine(SCR),Blood nitrogen(BUN),Fasting Blood glucose(Fasting Fasting)and Fasting Fasting Fasting Fasting Fasting Fasting Fasting Fasting Fasting Fasting Fasting Fasting Blood-glucose(FBG),Low density lipoprotein(LDL)were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 88.10%(37/42)significantly higher than that of the control group(66.67%,28/42),and the difference was statistically significant(P<0.05).There was no statistically significant difference in TCM syndrome scores between the two groups before treatment(P BBB 0.05).After treatment,TCM syndrome scores in the two groups were better than before treatment,and the treatment group was better than the control group,with statistical significance(P<0.05).Before treatment,there were no significant differences in EGFR,SCR,BUN,FBG and LDL between the two groups(P BBB 0.05).After treatment,the indexes of both groups were better than before treatment,and the indexes of SCR,BUN,FBG and LDL in the observation group were significantly lower than t

关 键 词：消渴 水肿 黄连温胆汤 糖尿病肾病 湿热中阻证 中医药疗法 黄腾蛟 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]