加味三仁汤治疗脾肾亏虚兼湿热壅滞型2型糖尿病肾病临床观察  

Efficacy observation of modified Sanren decoction on type 2 diabetic nephropathy with syndrome of deficiency of spleen-kidney and stagnation of damp-heat

作　　者：林慧婷 王体敬 LIN Hui-ting;WANG Ti-jing(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;不详)

机构地区：[1]山东中医药大学,济南250014 [2]山东省菏泽市中医医院

出　　处：《山西中医》2023年第7期23-25,共3页Shanxi Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(编号:2017-504)。

摘　　要：目的:观察加味三仁汤治疗脾肾亏虚兼湿热壅滞型2型糖尿病肾病(diabetic kidney disease,DKD)的临床疗效。方法:将78例2型糖尿病肾病3期患者随机分为两组各39例,对照组予常规治疗,治疗组在对照组基础上予加味三仁汤治疗,两组均连续治疗3个疗程,观察两组患者临床疗效,比较两组患者治疗前后空腹血糖(FBG),餐后2小时血糖(2hPG),糖化血红蛋白(HbA1c),24h尿微量白蛋白(24h mALB),血清胱抑素C(Cys-C),同型半胱氨酸(Hcy),β2微球蛋白(β2-MG),视黄醇结合蛋白(RBP)水平。结果:治疗后两组中医证候积分均较前降低(P﹤0.01),治疗组优于对照组(P﹤0.05);治疗后治疗组临床总有效率为84.62%,对照组为66.67%,治疗组优于对照组(P﹤0.05);治疗后两组患者24h mALB、Cys-C、Hcy、β2-MG、RBP水平均明显降低(P﹤0.05),且治疗组优于对照组(P﹤0.05)。结论:2型糖尿病肾病患者予加味三仁汤治疗,能显著改善患者的临床症状及尿微量白蛋白水平,疗效较好。Objective:To observe the clinical efficacy of modified Sanren decoction on type 2 diabetic nephropathy with syndrome of deficiency of spleen-kidney and stagnation of damp-heat.Methods:78 cases of patients with type 2 diabetic nephropathy in the third stage were randomly divided into two groups,39 cases in each group.The control group was routinely treated,while the treatment group was treated plus with modified Sanren decoction on the basis of control group.Both groups were treated continuously for three courses of treatment.The clinical efficacy of patients was observed in two groups.The levels of fasting blood glucose(FBG),2 hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),24h urinary microalbumin(24hmALB),serum cystatin C(Cys-C),homocysteine(Hcy),β2 microglobulin(β2-MG)and retinol-binding protein(RBP)of patients were compared between two groups before and after treatment.Results:After treatment in both groups:TCM syndrome scores were decreased compared with before treatment(P﹤0.01),and the treatment group was better than control group(P﹤0.05);the clinical total effective rate was 84.6%in the treatment group and 66.6%in the control group,and the treatment group was better than control group(P﹤0.05);the levels of 24h mALB,Cys-C,Hcy,β2-MG and RBP of patients were significantly decreased(P﹤0.05),and the treatment group was better than control group(P﹤0.05).Conclusion:Modified Sanren decoction can significantly improve the symptoms and urinary microalbumin of patients with type 2 diabetic nephropathy,and its clinical efficacy is better.

关 键 词：2型糖尿病肾病 脾肾亏虚 湿热壅滞 加味三仁汤 中医药疗法 

分 类 号：R587.1[医药卫生—内分泌]