参芪地黄汤合桃红四物汤化裁治疗Ⅲ~Ⅳ期糖尿病肾脏病疗效及对氧化应激的影响  

Efficacy of Ginseng Astragalus Rehmannia decoction plus decoction of four ingredients including Peach Kernel and Safflower on stageⅢ~Ⅳdiabetic kidney disease and its effect on oxidative stress

作　　者：白璐 郭帅[1,2] 陈永哲 王倩 李敏[1,2] 沈士朋 刘茂东 BAI Lu;GUO Shuai;CHEN Yongzhe;WANG Qian;LI Min;SHEN Shipeng;LIU Maodong(The Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China;Hebei Key Laboratory of Diabetic Kidney Diseases,Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北医科大学第三医院,河北石家庄050051 [2]河北省糖尿病肾脏疾病重点实验室,河北石家庄050051

出　　处：《现代中西医结合杂志》2024年第6期772-777,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2022408)。

摘　　要：目的观察参芪地黄汤合桃红四物汤化裁治疗Ⅲ~Ⅳ期糖尿病肾脏病(DKD)患者的临床疗效及对氧化应激指标的影响。方法选取2021年3月—2023年3月就诊于河北医科大学第三医院肾内科门诊及住院的126例DKD患者,随机分为对照组及观察组,每组63例。2组患者均接受常规西医治疗,观察组同时给予参芪地黄汤合桃红四物汤化裁方治疗,2组均治疗12周。观察2组治疗前后中医证候积分及肾功能指标[24 h尿蛋白定量及血清尿素氮(BUN)、血肌酐(SCr)]、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、血流变学指标(纤维蛋白原、血浆黏度、全血黏度)、氧化应激指标[血浆丙二醛(MDA)、超氧化物歧化酶(SOD)]变化,统计2组临床疗效、终点事件和不良反应发生情况。结果对照组59例、观察组58例完成研究。2组治疗后中医证候积分及24h尿蛋白定量、BUN、SCr、FPG、HbA1c、TC、TG、纤维蛋白原、血浆黏度、全血黏度、MDA水平均明显降低(P均<0.05),SOD水平均明显升高(P均<0.05);治疗后观察组中医证候积分及24 h尿蛋白定量、BUN、纤维蛋白原、血浆黏度、全血黏度、MDA水平均明显低于对照组(P均<0.05),SOD水平明显高于对照组(P<0.05)。治疗后,观察组的总有效率明显高于对照组[84.48%(49/58)比66.10%(39/59),P<0.05]。2组终点事件和不良反应发生率比较差异均无统计学意义(P均>0.05)。结论参芪地黄汤合桃红四物汤化裁能有效减轻Ⅲ~Ⅳ期DKD患者的临床症状,减少尿蛋白排泄,保护肾功能,改善糖脂代谢紊乱,调节血液高凝状态,抗氧化应激,效果优于常规西医治疗。Objective It is to observe the clinical efficacy of Ginseng Astragalus Rehmannia decoction plus decoction of four ingredients including Peach Kernel and Safflower on stageⅢⅣdiabetic kidney disease(DKD)and its effect on oxidative stress.Methods A total of 126 DKD patients treated at the Outpatient Clinic and Inpatient Department of Nephrology of the Third Hospital of Hebei Medical University from March 2021 to March 2023 were selected and randomly divided into control group and observation group,with 63 patients in each group.Both groups were treated with conventional western medicine,additionally,the observation group was treated with modified Ginseng Astragalus Rehmannia decoction plus decoction of four ingredients including Peach Kernel and Safflower,and both groups were treated for 12 weeks.The changes of Chinese medicine syndrome scores and renal function indexes[24 h urine protein quantification and blood urea nitrogen(BUN),serum creatinine(SCr)],fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triacylglycerol(TG),blood rheology indexes(fibrinogen,plasma viscosity,whole blood viscosity),oxidative stress indexes[plasma malondialdehyde(MDA),superoxide dismutase(SOD)]before and after treatment in the two groups were observed,and the clinical efficacy,occurrences of endpoint events and adverse reactions of the two groups were calculated.Results Fifty-nine cases in the control group and 58 cases in the observation group completed the study.The syndrome scores and levels of 24 h urine protein quantification,BUN,SCr,FPG,HbA1c,TC,TG,fibrinogen,plasma viscosity,whole blood viscosity and MDA were significantly decreased,while the levels of SOD were significantly increased after treatment in the two groups(all P<0.05),the syndrome scores and levels of 24 h urine protein quantification,BUN,fibrinogen,plasma viscosity,whole blood viscosity and MDA were significantly lower,while the level of SOD was significantly higher after treatment in the observation group than those in the control

关 键 词：参芪地黄汤 桃红四物汤 糖尿病肾脏病 蛋白尿 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]