参芪地黄汤加减联合西药治疗Ⅳ期糖尿病肾病气阴两虚兼血瘀证临床研究  

Clinical Study on Modified Shenqi Dihuang Decoction Combined with Western Medicine for Stage Ⅳ Diabetic Nephropathy of Qi-Yin Deficiency and Blood Stasis Syndrome

作　　者：吴睿轩[1] 王婷婷[1] 刘张红[1] WU Ruixuan;WANG Tingting;LIU Zhanghong

机构地区：[1]温州市中医院肾病科,浙江温州325000

出　　处：《新中医》2023年第6期1-5,共5页New Chinese Medicine

基　　金：温州市科研项目(Y20190550)。

摘　　要：目的:观察参芪地黄汤加减联合西药治疗Ⅳ期糖尿病肾病(DN)气阴两虚兼血瘀证的临床疗效。方法:将62例Ⅳ期DN气阴两虚兼血瘀证患者以随机数字表法分为治疗组和对照组各31例。2组均给予降糖药物等基础治疗,对照组予以盐酸贝那普利片、氯沙坦钾氢氯噻嗪片等西药治疗,治疗组加予参芪地黄汤加减治疗,2组均治疗2个月。比较2组临床疗效,治疗前后24 h尿蛋白定量、血清超敏C-反应蛋白(hs-CRP)、血糖[空腹血糖(FBG)、餐后2 h血糖(P2hBG)]及氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平。结果:治疗后,治疗组临床疗效总有效率93.55%,高于对照组70.97%,差异有统计学意义(P<0.05)。2组24 h尿蛋白定量、血清hs-CRP水平均较治疗前降低(P<0.05);治疗组24 h尿蛋白定量、血清hs-CRP水平均低于对照组(P<0.05)。2组FBG、P2hBG水平均较治疗前降低(P<0.05);但组间比较,差异均无统计学意义(P>0.05)。2组血清MDA水平均较治疗前降低(P<0.05),血清SOD水平均较治疗前升高(P<0.05);治疗组血清MDA水平低于对照组(P<0.05),血清SOD水平高于对照组(P<0.05)。结论:参芪地黄汤加减联合西药治疗Ⅳ期DN气阴两虚兼血瘀证可提高临床疗效,减轻肾脏损伤和机体炎症反应,控制血糖水平,调节氧化防御机能。Objective:To observe the clinical effect of Modified Shenqi Dihuang Decoction combined with western medicine for stage Ⅳ diabetic nephropathy(DN) of qi-yin deficiency and blood stasis syndrome. Methods: A total of 62 cases of patients with DN in stage Ⅳ and the syndrome of qi-yin deficiency and blood stasis were divided into the treatment group and the control group according to the random number table method,with 31 cases in each group. Both groups were given basic treatment such as hypoglycemic medicine, the control group was additionally treated with western medicine including Benazepril Hydrochloride Tablets, and Losartan Potassium Hydrochlorothiazide Tablets;the treatment group was additionally treated with Modified Shenqi Dihuang Decoction. Both groups were treated for2 months. The levels of 24-hour urine protein,serum high-sensitivity C-reactive protein(hs-CRP),blood glucose including fasting blood glucose(FBG) and postprandial 2-hour blood glucose(P2hBG),and oxidative stress indicators including malondialdehyde(MDA) and superoxide dismutase(SOD) before and after treatment,as well as clinical effects,were compared between the two groups. Results:After treatment,the total effective rate of clinical effect was 93.55% in the treatment group,higher than that of 70.97% in the control group, the difference being significant(P<0.05). The levels of 24-hour urine protein and hs-CRP in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the two levels in the treatment group were lower than those in the control group(P<0.05). The levels of FBG and P2hBG in the two groups were decreased when compared with those before treatment(P<0.05),but there were no significant difference between the two groups(P>0.05). The levels of MDA in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of SOD in serum were increased when compared with those before treatment(P<0.05);the level of MDA in serum in the treatment group was lower than t

关 键 词：糖尿病肾病 气阴两虚证 血瘀证 参芪地黄汤 24 h尿蛋白定量 超敏C-反应蛋白 血糖 氧化应激 

分 类 号：R587.2[医药卫生—内分泌]