益气养阴活血方联合西药治疗早期糖尿病肾病的临床研究  

Clinical study on the treatment of early diabetic nephropathy by combining western medicine with the Yiqi yangyin huoxue recipe

作　　者：史晗冰[1] 徐靖华[1] 刘建光[1] Shi Hanbing;Xu Jinghua;Liu Jianguang(Department of Emergency Medicine,The Fourth Hospital of Liaoning University of Chinese Medicine,Shenyang 110101,China)

机构地区：[1]辽宁中医药大学附属第四医院急诊科,沈阳110101

出　　处：《保健医学研究与实践》2021年第6期74-77,84,共5页Health Medicine Research and Practice

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目(辽财指社[2015]458号)。

摘　　要：目的探讨益气养阴活血方联合西药对早期糖尿病肾病(DKD)患者尿微量白蛋白、尿白蛋白/肌酐比值(UACR)、血尿素氮(BUN)、血清胱抑素-C(Cys-C)及肾小球滤过率(e GFR)的影响。方法选取2019年1月—2021年1月辽宁省某医院收治的86例早期DKD患者,采用随机数字表法分为观察组和对照组,每组43例。对照组患者采用常规西药治疗,观察组采用益气养阴活血方联合西药治疗,均持续治疗8周。比较2组患者的疗效及治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、甘油三酯(TG)、尿β2-微球蛋白(β2-MG)、BUN、肌酐(Cr)、Cys-C、e GFR、UACR、收缩压(SBP)、舒张压(DBP)水平及不良反应发生情况。结果观察组患者治疗总有效率为86.05%,高于对照组的67.44%,差异有统计学意义(χ^(2)=4.170,P=0.041)。2组患者治疗后FBG、Hb A1c、TC及TG水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者治疗后SBP、DBP、β2-MG、24 h尿蛋白定量水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者治疗后BUN、Cys-C、UACR、Cr和尿微量白蛋白水平低于治疗前且观察组低于对照组,e GFR水平高于治疗前且观察组高于对照组,差异均有统计学意义(P<0.05)。2组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.496,P=0.481)。结论益气养阴活血方联合西药可降低早期DKD患者血压、血脂、血糖水平,改善患者肾功能。Objective To investigate the effects of combining the yiqi yangyin huoxue recipe with western medicine on urinary microalbumin,urinary albumin/creatinine ratio(UACR),blood urea nitrogen(BUN),serum cystatin-C(Cys-C)and estimated glomerular filtration rate(e GFR)in patients with early diabetic kidney disease(DKD).Methods Eighty-six patients with early DKD admitted to a hospital in Liaoning Province from January 2019 to January 2021 were selected and divided into observation and control groups using the random number table method,with 43 cases in each group.Patients in the control group were treated with conventional western medicine,while the observation group was treated with the combination of western medicine with the yiqi yangyin huoxue recipe,both of which lasted for 8 weeks.The efficacy and the levels of fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1 c),total cholesterol(TC),triglycerides(TG),urinaryβ2-microglobulin(β2-MG),BUN,creatinine(Cr),Cys-C,e GFR,UACR,systolic blood pressure(SBP),diastolic blood pressure(DBP)and the occurrence of adverse reactions were compared between the two groups of patients before and after treatment.Results The total effective rate of treatment for patients in the observation group was 86.05%,higher than 67.44%in the control group,and the difference was statistically significant(χ^(2)=4.170,P=0.041).The levels of FBG,Hb A1 c,TC and TG in the 2 groups after treatment were lower than those before treatment,and they were lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).The levels of SBP,DBP,β2-MG,24 h urine protein quantification levels were lower than those before treatment in both groups and lower in the observation group than in the control group,and the differences were statistically significant(P<0.05).BUN,Cys-C,UACR,Cr and urine microalbumin levels were lower than those before treatment in both groups and lower in the observation group than in the control group,and e GFR levels were higher than th

关 键 词：益气养阴活血方 早期糖尿病肾病 尿微量白蛋白 尿白蛋白肌酐比值 血尿素氮 肾小球滤过率 

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