参芪降糖片联合胰岛素治疗脾肾两虚型早期糖尿病肾病的临床研究  

Clinical Study on Shenqi Jiangtang Tablets(参芪降糖片)Combined with Insulin Alleviating Early Diabetic Nephropathy with Deficiency of Spleen and Kidney

作　　者：吴晓珲 吴锐谦 林沛良 吴煜 周神龙 何秀玲 冯婉枝 区觉璋 WU Xiaohui;WU Ruiqian;LIN Peiliang;WU Yu;ZHOU Shenong;HE Xiuling;FENG Wanzhi;QU Juezhang(College of Traditional Chinese Medicine,Jinan University,Guangzhou 510632,Guangdong,China;Guangzhou Key Laboratory of Traditional Chinese Medicine Prescriptions,Jinan University,Guangzhou 510632,Guangdong,China;Guangdong Key Laboratory of TCM Informatization,Guangzhou 510632,Guangdong,China;Qingshuiwan Yiyang Rehabilitation Hospital,Shangrao 334000,Jiangxi,China;Traditional Chinese Medicine Hospital of Shangrao,Jiangxi 334000,China;Jiangmen Hospital of Traditional Chinese Medicine(Wuyi Hospital of Traditional Chinese Medicine),Jiangmen 529000,Guangdong,China)

机构地区：[1]暨南大学中医学院,广东广州510632 [2]暨南大学广州市中医方证重点实验室,广东广州510632 [3]广东省中医药信息化重点实验室,广东广州510632 [4]清水湾怡养康复医院,江西上饶334000 [5]上饶市中医院,江西上饶334000 [6]暨南大学附属江门中医院(五邑中医院),广东江门529000

出　　处：《中华中医药学刊》2024年第2期236-239,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：广东省科技计划项目(2021B1212040007);广州市科技计划项目(202102010014)。

摘　　要：目的探讨参芪降糖片联合胰岛素治疗脾肾两虚型早期糖尿病肾病的临床研究。方法选择2020年9月—2021年12月96例确诊为脾肾两虚型糖尿病肾病3期患者作为研究对象,采用随机数字法平均分为观察组与对照组两组:对照组给予胰岛素治疗方案,观察组在对照组基础上辅以参芪降糖片治疗。比较两组治疗前后中医证候评分差异,比较治疗4周后血糖控制情况、肾功能及实验室指标。结果观察组总有效率91.67%(44/48)明显高于对照组74.00%(35/48),差异比较有统计学意义(P<0.05)。治疗后两组空腹血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2 hours postprandial blood glucose,2 h PG)及糖化血红蛋白(Glycated hemoglobin,HbAlc)均较治疗前有明显降低(P<0.05);治疗后观察组FBG、2h PG及HbA1c均较对照组降低更明显(P<0.05)。治疗后两组患者尿微量白蛋白(Microalbumin,m-ALB)、尿白蛋白排泄率(Urinary albumin excretion rates,UAER)、β2微球蛋白(β2 Microglobulin,β2-MG)及半胱氨酸蛋白酶抑制剂C(Cysteine protease inhibitor C,Cys-C)均较治疗前降低(P<0.05);治疗4周后观察组尿mAlb、UAER、β2-MG及Cys-C均低于对照组(P<0.05)。治疗后两组患者血管内皮生长因子(Vascular endothelial growth factor,VEGF)、血管紧张素转化酶(Angiotensin converting enzyme,ACE)及胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)均较治疗前降低(P<0.05);治疗4周后观察组VEGF、ACE及IGF-1均低于对照组(P<0.05)。结论参芪降糖片联合胰岛素治疗脾肾两虚型早期糖尿病肾病可以更好控制血糖,改善症状,且延缓或逆转肾损伤效果更明显。Objective The current manuscript investigated the clinical activities of Shenqi Jiangtang Tablets(参芪降糖片)combined with insulin in the treatment of early diabetic nephropathy of deficiencyin spleen and kidney.Methods From September 2020 to December 2021,96 patients diagnosed as diabetic nephropathy in stage 3 due to deficiency of both spleen and kidney,and they were equally divided into the observation group and the control group with random number method.The control group was treated with insulin only,and the observation group was treated with insulin and Shenqi Jiangtang Tablets.The difference in TCM syndrome scores between the two groups before and after treatment was compared as well as the control of blood glucose,renal function and laboratory indexes four weeks after treatment.Results The total effective rate(91.67%)in the observation group was significantly higher than 74.00% in the control group with significance(P<0.05).After treatment,the levels of FBG,2 h PG and HbA1c in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of urinary mAlb,UAER,β2-MG,Cys-C,mAlb,UAER,β2-MG and Cys-C in the two groups were lower than those before treatment(P<0.05).After treatment,the levels of VEGF,ACE and IGF-1 were all lower in the two groups than those before treatment(P<0.05).Four weeks after treatment,the levels of VEGF,ACE and IGF-1 in the observation group were lower than those in the control group(P<0.05).Conclusion Shenqi Jiangtang Tablets combined with insulin can significantly alleviate the diabetic nephropathy with deficiency of spleen and kidney by stabilizing blood glucose and inhibiting kidney injury.

关 键 词：参芪降糖片 胰岛素 门冬胰岛素 糖尿病肾病 脾肾两虚 

分 类 号：R259.872[医药卫生—中西医结合]