中药复方益肾康加减治疗气阴两虚兼血瘀证早期糖尿病肾病疗效观察及对炎症因子影响  

Therapeutic Effect of Yishenkang(益肾康)on Early Diabetic Kidney Disease with Qi Yin Deficiency and Blood Stasis Syndrome and Its Effect on Inflammatory Factors

作　　者：张颖[1,2] 黄奡[2] 张兰 ZHANG Ying;HUANG Ao;ZHANG Lan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2023年第1期188-192,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：全国名老中医专家传承工作室建设项目(2022-75);辽宁中医附属医院“育苗工程”项目(YM202119)。

摘　　要：目的 观察益肾康治疗早期糖尿病肾病(diabetic kidney disease,DKD)气阴两虚兼血瘀证患者的临床疗效及对血清炎症因子白介素-1β(IL-1β)、白介素-18(IL-18)的调节作用。方法 选取2019年1月—2021年1月就诊于辽宁中医药大学附属医院内分泌科确诊为气阴两虚兼血瘀证的早期DKD患者96例,采用随机对照研究方法,对照组(n=48)进行西医综合治疗(包括生活方式干预、控制血糖、控制血压、调脂),中药组(n=48)在对照组的基础上,加用益肾康煎剂100 mL,日3次口服;两组患者均持续治疗12周。观察两组患者临床疗效、尿微量白蛋白/尿肌酐(UACR)、中医证候评分、临床蛋白尿发生率,以及血清炎症因子IL-1β、IL-18的水平。结果 中药组治疗临床总有效率(83.33%)高于对照组(60.47%)(P<0.05);与治疗前相比,两组患者治疗后UACR均有所降低,但中药组差异具有统计学意义(P<0.01),而对照组差异无统计学意义(P>0.05);治疗后两组患者中医证候评分整体均呈下降趋势,且中药组中医证候评分下降更明显(P<0.01);两组患者临床蛋白尿发生率方面比较差异无统计学意义(P>0.05);与治疗前比较,治疗后两组患者血清IL-1β、IL-18水平均有所降低(P<0.01),与对照组相比,中药组患者血清IL-1β、IL-18水平降低更明显,差异有统计学意义(P<0.01)。结论 益肾康联合西医综合疗法治疗早期2型糖尿病肾病能提高临床疗效,改善患者中医症状,降低蛋白尿,减轻机体炎症反应,且安全性良好。Objective Through clinical research,to observe the clinical efficacy of Yishenkang(益肾康)in the treatment of early diabetic kidney disease(DKD)patients with Qi and Yin deficiency and blood stasis syndrome and the regulation of serum inflammatory factor IL-1βand IL-18.Methods 96 patients with early DKD diagnosed as Qi and Yin deficiency and blood stasis syndrome were selected from the department of endocrinology of the affiliated hospital of Liaoning university of traditional Chinese medicine(TCM)from January 2019 to January 2021,a randomized controlled study method was adopted.The control group(n=48)received comprehensive treatment of Western medicine(including lifestyle intervention,control of blood glucose,blood pressure and blood lipid).TCM group(n=48)added Yishenkang on the basis of the control group,1 dose/d,three times orally;Both groups were treated for 12 weeks.The clinical efficacy,UACR,TCM syndrome score,the incidence of clinical proteinuria and the level of serum IL-1β,IL-18were observed.Results The total effective rate of traditional Chinese medicine group was 83.33%,which was higher than 60.47%in the control group(P<0.05);Compared with before treatment,UACR in both groups decreased after treatment,but UACR in TCM group decreased significantly(P<0.01),while there was no significant difference between UACR in control group and before treatment(P>0.05);After treatment,the TCM syndrome score of the two groups showed a downward trend,and the TCM syndrome score of the TCM group decreased more significantly(P<0.01);There was no significant difference in the incidence of clinical proteinuria between the two groups(P>0.05);After treatment,the concentration of serum IL-β,IL-18 in the two groups decreased(P<0.01).Compared with the control group,the concentration of serum IL-β,IL-18 in the TCM group decreased more significantly(P<0.01).Conclusion Yishenkang combined with western medicine in the treatment of early type 2 diabetic nephropathy can improve clinical curative effect,improve TCM symptoms,reduce

关 键 词：糖尿病肾脏病 益肾康 补肾健脾活血法 炎症 临床研究 

分 类 号：R587.2[医药卫生—内分泌]