益肾健脾利水泄浊法治疗糖尿病肾病疗效分析  

Effect analysis of tonifying kidney,invigorating spleen,promoting diuresis and removing turbidity therapy on diabetes nephropathy

作　　者：王秀莹 赵长松 张文龙 WANG Xiu-ying;ZHAO Chang-song;ZHANG Wen-long(Tangshan Hospital of TCM,Tangshan 063099)

机构地区：[1]河北省唐山市中医医院,河北唐山063099

出　　处：《湖北中医药大学学报》2024年第4期36-39,共4页Journal of Hubei University of Chinese Medicine

基　　金：河北省中医药管理局项目(项目编号:ts202008014)。

摘　　要：目的观察益肾健脾利水泄浊法在糖尿病肾病(DN)患者中的应用效果。方法将我院120例DN患者随机分为观察组与对照组各60例。两组均行基础治疗后,对照组使用益气滋阴活血化瘀法治疗,观察组使用益肾健脾利水泄浊法治疗。比较两组临床疗效,治疗前后肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)等炎症指标,空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2h血糖(2hPG)等血糖指标,血肌酐(SCr)、胱抑素C(CysC)、尿白蛋白(mAlb)、尿素氮(BUN)、肾小球滤过率(eGFR)等肾功能指标,超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(T-AOC)等氧化反应指标,CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)等免疫功能指标;开展肠道菌群监测,寻找特征差异菌群。结果治疗后观察组总有效率显著高于对照组(P<0.05);两组TNF-α、CRP、IL-6、FPG、HbA1c、2hPG、mAlb、BUN、SCr、CysC、MDA、CD8^(+)水平均低于治疗前(P<0.05),观察组上述指标均低于对照组(P<0.05);两组双歧杆菌、大肠杆菌、乳酸杆菌、拟杆菌、肠球菌、B/E值、eGFR、SOD、T-AOC、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于治疗前(P<0.05),观察组上述指标均高于对照组(P<0.05)。结论益肾健脾利水泄浊法治疗糖尿病肾病疗效较好,能有效改善病情,改善血糖水平及肾功能,其作用机制在于调节肠道菌群,改善炎症、氧化应激、免疫。Objective To observe the application effect of tonifying kidney,invigorating spleen,promoting diuresis and removing turbidity therapy in patients with diabetes nephropathy(DN).Methods 120 patients with DN were randomly divided into observation group and control group,with 60 cases each.After basic treatment,control group was treated with tonifying qi,nourishing yin,promoting blood circulation,and removing blood stasis therapy,while observation group was treated with tonifying kidney,invigorating spleen,promoting diuresis and removing turbidity therapy.Comparing the curative effect and inflammatory response indicators,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),blood glucose indicators fasting blood glucose(FPG),glycated hemoglobin(HbA1c),postprandial 2-hour blood glucose(2hPG),renal function indicators blood creatinine(SCR),cystatin C(CysC),urinary albumin(mAlb),urea nitrogen(BUN),glomerular filtration rate(eGFR),oxidative response indicators superoxide dismutase(SOD),malondialdehyde(MDA),total anti-oxidative capacity(T-AOC),immune function indicators CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+);simultaneously conducting monitoring of gut microbiota to identify characteristic differences in microbiota.Results After treatment,the total clinical treatment effectiveness rate of observation group was higher than that of control group(P<0.05);TNF-α,CRP,IL-6,FPG,HbA1c,2 hPG,mAlb,BUN,SCr,CysC,MDA,and CD8^(+)in both groups were all lower than those before treatment(P<0.05),and were all lower in observation group than those in control group(P<0.05),while Bifidobacterium,Escherichia coli,Lactobacillus,Bacteroides,Enterococcus,B/E value,eGFR,SOD,T-AOC,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in both groups were all higher than those before treatment(P<0.05),and were all higher in observation group than those in control group(P<0.05).Conclusion Tonifying kidney,invigorating spleen,promoting diuresis and removing turbidity therapy has better effect,which can effectively improve the condition,blood sugar lev

关 键 词：糖尿病肾病 益肾健脾利水泄浊法 益气滋阴活血化瘀法 

分 类 号：R259[医药卫生—中西医结合]