自拟济肾方加减治疗2型糖尿病肾脏疾病(Ⅲ期)气阴两虚兼血瘀证临床研究  

Clinical study on modified self-made Jishen prescription for treatment of type 2 diabetic nephropathy(phaseⅢ)with deficiency of both Qi and Yin and blood stasis

作　　者：连书光 张琼瑶 刘海立 杨英武 Lian Shuguang;Zhang Qiongyao;Liu Haili;Yang Yingwu(Department of Nephrology,Ruzhou Jiren Diabetes Hospital,Ruzhou 467599,China;General Practice Department and Hypertension Department of Zhengzhou Second People's Hospital,Zhengzhou 450006,China)

机构地区：[1]河南省汝州市济仁糖尿病医院肾病科,汝州467599 [2]郑州市第二人民医院全科医学科高血压科,郑州450006

出　　处：《国际中医中药杂志》2022年第2期159-163,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的评价自拟济肾方加减结合西医常规疗法治疗2型糖尿病肾脏疾病(diabetic kidney disease,DKD)Ⅲ期气阴两虚兼血瘀证的疗效。方法将符合入选标准的2019年2月-2020年7月汝州市济仁糖尿病医院DKDⅢ期气阴两虚兼血瘀证患者80例,按就诊顺序随机分为2组,每组40例。对照组采用西医常规疗法治疗,治疗组在对照组基础上服用自拟济肾方加减治疗。2组均治疗3个月。分别于治疗前后进行中医症状评分;采用己糖激酶法检测空腹血糖(FPG),肌氨酸氧化酶法检测SCr并计算肾小球滤过率(eGFR),胶乳增强免疫比浊法检测超敏C反应蛋白(hs-CRP),夹心ELISA法检测TGF-β1水平,HPLC法检测HbA1c;收集24 h尿液,采用邻苯三酚红钼法检测24 h尿蛋白定量(24 hUTP);评价临床疗效。结果治疗组总有效率为87.5%(35/40)、对照组为67.5%(27/40),2组比较差异有统计学意义(Z=-2.72,P=0.006)。治疗后,治疗组hs-CRP[(2.52±1.02)mg/L比(3.21±1.22)mg/L,t=2.74]、TGF-β1[(32.2±6.52)mg/L比(38.3±6.8)mg/L,t=-4.97]、24 hUTP[(120.91±38.84)mg比(144.84±49.69)mg,t=-5.94]水平低于对照组(P<0.05);eGFR[(66.23±4.91)ml·min^(-1)·1.73 m^(-2)比(59.69±4.51)ml·min^(-1)·1.73 m^(-2),t=6.61]高于对照组(P<0.05)。治疗组治疗后中医症状积分低于对照组(t=-5.09,P<0.01)。结论自拟济肾方加减结合西医常规疗法可抑制DKDⅢ期气阴两虚兼血瘀证患者炎症反应及肾间质纤维化,改善eGFR,减少尿蛋白排泄,疗效优于西医常规疗法治疗。Objective This paper is to evaluate the curative effect of Self-made Jishen prescription combined with conventional western medicine in the treatment of type 2 diabetic kidney disease(DKD)with both deficiency of both qi and yin and blood stasis.Methods A total of 80 patients from February 2019 to July 2020 with the syndrome of deficiency of both Qi and Yin with blood stasis in the DKDⅢstage of Ruzhou Jiren Diabetes Hospital were selected.Those patients who met the diagnostic criteria were randomly divided into 2 groups,the control group and the treatment group,according to registration orders,with 40 in each group.The control group was treated with conventional western medicine therapy,and the treatment group was treated with modified self-made Jishen prescription on the basis of the control group.The treatment of both groups lasted for 3 months.Traditional Chinese Medicine(TCM)symptoms were scored before and after the treatment;hexokinase method was used to detect FPG,sarcosine oxidase method was used to detect SCr and eGFR were calculated,latex enhanced turbidimetric inhibition immuno assay method was used to detect hypersensitive C-reactive protein(hs-CRP),the sandwich ELISA was used to detect transforming growth factor-β1(TGF-β1),and HbA1c was detected by high performance liquid chromatography;24 h urine was collected,and 24 hUTP was detected by pyrogallol red-molybdenum method;and the clinical efficacy was evaluated.Results The total effective rate was 87.5%(35/40)in the treatment group and 67.5%(27/40)in the control group.The difference between the two groups was statistically significant(Z=-2.72,P=0.006).After treatment,hs-CRP[(2.52±1.02)mg/L vs.(3.21±1.22)mg/L,t=2.74],TGF-β1[(32.2±6.52)mg/L vs.(38.3±6.8)mg/L,t=-4.97],24 hUTP[(120.91±38.84)mg vs.(144.84±49.69)mg,t=-5.94]in the treatment group were significantly lower than those in the control group(P<0.05);eGFR[(66.23±4.91)ml·min^(-1)·1.73m^(-2) vs.(59.69±4.51)ml·min^(-1)·1.73m^(-2),t=6.61]in the treatment group was significantly higher th

关 键 词：糖尿病 2型 糖尿病肾脏疾病 糖尿病并发症 气阴两虚证 血瘀证 自拟济肾方 中西医结合疗法 

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