清心莲子饮加减治疗糖尿病肾脏病Ⅲ~Ⅳ期气阴两虚证的临床观察  

Clinical Effects of Modified Qingxin Lianzi Decoction on Diabetic Kidney Disease at Stage Ⅲ to Ⅳ with Deficiency of both Qi and Yin

作　　者：张丽香[1,2] 王钢[3] 丘余良[1] 陈翔[4] 王思黎[4] ZHANG Lixiang;WANG Gang;QIU Yuliang(The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou,350004;Nanjing University of Chinese Medicine,Nanjing,210029)

机构地区：[1]福建中医药大学附属人民医院肾病科,福州350004 [2]南京中医药大学,南京210029 [3]南京中医药大学附属南京博大肾科医院,南京210004 [4]福建中医药大学,福州350122

出　　处：《中国中西医结合肾病杂志》2024年第9期778-782,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：福建中医药大学校管项目(No.XB2021005);福建省教育厅中青年教师教育科研项目(科技类)(No.JAT210181);国家中医药管理局第五批全国中医临床优秀人才研修项目(No.国中医药人教函[2022]1号);福建省中医药科研计划项目(No.2021ZYLC028);福建中医药大学附属人民医院科研项目(No.ZXKT004)。

摘　　要：目的:观察清心莲子饮加减方治疗糖尿病肾脏病(DKD)Ⅲ~Ⅳ期气阴两虚证患者的临床疗效。方法:选取2021年10月—2024年3月福建中医药大学附属人民医院收治的DKDⅢ~Ⅳ期气阴两虚证患者60例,随机分为两组,每组各30例。对照组予西医常规治疗如降压、降糖等,治疗组同时加服清心莲子饮加减方。连续治疗8周后,比较两组患者的临床疗效、肾功能、空腹血糖(FBG)、24 h尿蛋白定量(24 h UTP)、糖基化终末产物(AGEs)、白细胞介素6(IL-6)及中医证候积分等的影响。结果:(1)治疗后,治疗组总有效率优于对照组(P<0.05);(2)两组FBG、血尿酸(UA)及证候积分均较治疗前明显降低(P<0.05,P<0.01);治疗组Scr、eGFR、BUN、24 h UTP、AGEs及IL-6均较治疗前明显改善(P<0.01),而对照组上述指标较治疗前无明显变化(P>0.05);(3)治疗后,治疗组AGEs、IL-6、FBG、24 h UTP及中医证候积分明显低于对照组(P<0.05),而两组Scr、eGFR、BUN及UA差异无统计学意义(P>0.05)。结论:清心莲子饮加减方可有效减轻DKDⅢ~Ⅳ期气阴两虚证患者症状,平稳控制血糖,减少尿蛋白,减轻氧化应激和炎症反应,改善肾功能,提高临床疗效,延缓DKD进展。Objective:To observe the clinical effect of Modified Qingxin Lianzi Decoction in patients with diabetic kidney disease(DKD)at stageⅢtoⅣwith deficiency of both Qi and Yin.Methods:A total of 60 patients with diabetic kidney disease(DKD)at stageⅢtoⅣwith deficiency of both Qi and Yin,who were admitted to The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from October 2021 to March 2024,were randomly divided into two groups,with 30 patients in each group.The control group received conventional Western medicine treatments such as antihypertensive and hypoglycemic therapies and other therapeutic methods,while the treatment group received Modified Qingxin Lianzi Decoction orally in combination with Western medicine treatment.After continuous treatment for 8 weeks,the clinical efficacy,renal function,fasting blood glucose(FBG),24-hour urine total protein(24 h-UTP),advanced glycation end-products(AGEs),interleukin-6(IL-6),and Traditional Chinese Medicine(TCM)syndrome scores were compared between the two groups.Results:(1)After treatment,the total effective rate in the treatment group was better than that in the control group(P<0.05).(2)Both groups showed significant reductions in FBG,serum uric acid(UA),and TCM syndrome scores compared to before treatment(P<0.05,P<0.01);compared to before treatment,the levels of serum creatinine(Scr),estimated glomerular filtration rate(eGFR),blood urea nitrogen(BUN),24 h-UTP,AGEs,and IL-6 were significantly improved in the treatment group(P<0.01),while there were no significant changes in the control group(P>0.05).(3)After treatment,the levels of AGEs,IL-6,FBG,24 h-UTP and TCM syndrome scores in the treatment group were significantly lower than those in the control group(P<0.05),while there were no significant differences in Scr,eGFR,BUN and UA between the two groups(P>0.05).Conclusion:Modified Qingxin Lianzi Decoction can effectively alleviate the clinical symptoms of patients with DKD at stageⅢtoⅣwith deficiency of both Qi and Yin,maintain

关 键 词：清心莲子饮 糖尿病肾脏病 气阴两虚证 糖基化终末产物 白细胞介素6 

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