益气养阴消癥通络汤治疗早期糖尿病肾病的临床效果  

Clinical effect of Yiqi Yangyin Xiaozheng Tongluo Decoction on early diabetic nephropathy

作　　者：张智珍 罗文娟 范燕 黄艳梅 刘康文 ZHANG Zhi-zhen;LUO Wen-juan;FAN Yan(Nankang District Hospital of Traditional Chinese Medicine,Ganzhou 341400,China)

机构地区：[1]赣州市南康区中医院,341400

出　　处：《中国实用医药》2024年第6期149-152,共4页China Practical Medicine

摘　　要：目的 探讨益气养阴消癥通络汤治疗早期糖尿病肾病(DN)的临床效果。方法 64例早期糖尿病肾病患者,随机分为对照组和观察组,每组32例。对照组使用常规西药治疗,在此基础上,观察组使用益气养阴消癥通络汤治疗。比较两组临床疗效,血糖及肾功能指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、血肌酐(SCr)、尿素氮(BUN)、尿白蛋白排泄率(UAER)],中医证候积分,血液流变学指标[血浆粘度、全血高切粘度、全血低切粘度、纤维蛋白原(FIB)、D-二聚体(D-D)]。结果 观察组治疗总有效率为93.75%,明显高于对照组的75.00%(P<0.05)。观察组治疗后FBG、2 h PG、HbA1c、BUN、Scr、UAER分别为(6.35±0.90)mmol/L、(8.97±1.25)mmol/L、(6.71±0.86)%、(5.95±1.04)mmol/L、(120.73±17.68)μmol/L、(75.70±10.67)μg/min,均低于对照组的(7.84±1.21)mmol/L、(10.96±1.78)mmol/L、(8.10±0.93)%、(8.67±1.39)mmol/L、(135.06±19.28)μmol/L、(109.31±12.75)μg/min(P<0.05)。观察组治疗后咽干口渴、手足心热、神疲乏力、腰痛膝软、肢体水肿等中医证候积分分别为(0.98±0.16)、(0.92±0.15)、(1.01±0.21)、(0.96±0.18)、(0.95±0.20)分,均明显低于对照组的(1.53±0.21)、(1.49±0.20)、(1.75±0.24)、(1.50±0.23)、(1.48±0.23)分(P<0.05)。观察组治疗后血浆粘度、全血高切粘度、全血低切粘度、FIB、D-D分别为(1.23±0.21)mPa·s、(3.67±0.68)mPa·s、(8.74±1.36)mPa·s、(2.62±0.37)g/L、(1.90±0.35)μg/ml,均低于对照组的(1.88±0.25)mPa·s、(5.14±0.79)mPa·s、(11.08±1.93)mPa·s、(3.29±0.45)g/L、(2.68±0.40)μg/ml(P<0.05)。结论 益气养阴消癥通络汤治疗早期糖尿病肾病的临床效果显著,能提高血糖控制效果,改善肾功能,降低血液粘稠度,缓解证候。Objective To explore the clinical effect of Yiqi Yangyin Xiaozheng Tongluo Decoction on early diabetic nephropathy(DN).Methods 64 patients with early diabetic nephropathy were randomly divided into a control group and an observation group,with 32 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Yiqi Yangyin Xiaozheng Tongluo Decoction.Both groups were compared in terms of clinical efficacy,blood glucose and renal function indicators[fasting blood glucose(FBG),2 h postprandial glucose(2 h PG),glycated hemoglobin(HbA1c),serum creatinine(SCr),blood urea nitrogen(BUN),urinary albumin excretion rate(UAER)],traditional Chinese medicine syndrome score,hemorheological parameters[plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,fibrinogen(FIB),D-dimer(D-D)].Results The total effective rate of the observation group was 93.75%,which was significantly higher than 75.00%of the control group(P<0.05).After treatment,FBG,2 h PG,HbA1c,BUN,Scr and UAER of the observation group were(6.35±0.90)mmol/L,(8.97±1.25)mmol/L,(6.71±0.86)%,(5.95±1.04)mmol/L,(120.73±17.68)μmol/L and(75.70±10.67)μg/min,which were lower than(7.84±1.21)mmol/L,(10.96±1.78)mmol/L,(8.10±0.93)%,(8.67±1.39)mmol/L,(135.06±19.28)μmol/L and(109.31±12.75)μg/min of the control group(P<0.05).After treatment,the scores of traditional Chinese medicine syndrome such as dry throat and thirst,hot hands and feet,fatigue,lumbago and knee weakness,limb edema in the observation group were(0.98±0.16),(0.92±0.15),(1.01±0.21),(0.96±0.18)and(0.95±0.20)points,which were significantly lower than(1.53±0.21),(1.49±0.20),(1.75±0.24),(1.50±0.23)and(1.48±0.23)points in the control group(P<0.05).After treatment,the plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,FIB and D-D of the observation group were(1.23±0.21)mPa·s,(3.67±0.68)mPa·s,(8.74±1.36)mPa·s,(2.62±0.37)g/L and(1.90±0.35)μg/ml,which were lower than(1.88±0

关 键 词：早期糖尿病肾病 益气养阴消癥通络汤 肾功能 血糖 血液流变学 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]