益肾通络方加减治疗对糖尿病肾病患者中医证候积分、肾功能及尿微量白蛋白、足糖萼蛋白、PAI-1的影响  

Effects of modified Yishen Tongluo Decoction on scores of traditional Chinese medicine syndrome,renal function,urinary microalbumin,podocalyxin and PAI-1 in patients with diabetic nephropathy

作　　者：张帆 黄轶峰 屈雪平 刘玉茹 ZHANG Fan;HUANG Yi-feng;QU Xue-ping(General Practice,Beijing Chaoyang District Jinsong Community Health Service Center,Beijing 100022,China)

机构地区：[1]北京市朝阳区劲松社区卫生服务中心全科,100022 [2]北京市朝阳区亚运村社区卫生服务中心心内科,100101

出　　处：《中国实用医药》2024年第20期156-159,共4页China Practical Medicine

摘　　要：目的探讨益肾通络方加减治疗对糖尿病肾病患者中医证候积分、肾功能及尿微量白蛋白、足糖萼蛋白、纤溶酶原激活物抑制剂-1(PAI-1)的影响。方法80例糖尿病肾病患者,采用简单随机法分为益肾通络组和对照组,每组40例。对照组采用常规西医治疗,益肾通络组在对照组的基础上采用益肾通络方加减治疗。比较两组患者不良反应发生率,治疗前后中医证候积分、肾功能指标[血肌酐(Scr)、尿素氮(BUN)]及尿微量白蛋白、足糖萼蛋白、PAI-1水平。结果与治疗前相比,治疗后两组患者尿浊、气短懒言、腰肢酸痛及头晕多梦、尿频尿多、手足心热积分均降低,差异具有统计学意义(P<0.05);治疗后,益肾通络组患者尿浊、气短懒言、腰肢酸痛及头晕多梦、尿频尿多、手足心热积分均低于对照组,差异具有统计学意义(P<0.05)。治疗前,益肾通络组患者Scr、BUN水平分别为(213.63±8.61)μmol/L、(20.96±2.64)mmol/L,对照组分别为(214.21±8.49)μmol/L、(21.16±2.41)mmol/L;治疗后,益肾通络组患者Scr、BUN水平分别为(88.61±5.45)μmol/L、(11.36±2.64)mmol/L,对照组分别为(98.64±5.14)μmol/L、(15.64±2.68)mmol/L。与治疗前相比,治疗后两组患者Scr、BUN水平均降低,差异有统计学意义(P<0.05);治疗后,益肾通络组患者Scr、BUN水平低于对照组,差异有统计学意义(P<0.05)。治疗前,益肾通络组患者足糖萼蛋白、PAI-1、尿微量白蛋白水平分别为(13.63±3.61)ng/ml、(30.96±2.64)ng/ml、(92.16±10.48)mg/24 h,对照组分别为(14.21±3.49)ng/ml、(31.16±2.41)ng/ml、(92.39±10.31)mg/24 h;治疗后,益肾通络组患者足糖萼蛋白、PAI-1、尿微量白蛋白水平分别为(8.61±1.45)ng/ml、(21.36±2.64)ng/ml、(51.43±10.41)mg/24 h,对照组分别为(10.64±1.14)ng/ml、(25.64±2.68)ng/ml、(72.04±10.69)mg/24 h。与治疗前相比,治疗后两组患者尿微量白蛋白、足糖萼蛋白、PAI-1水平均降低,差异有统计学意义(P<0.0Objective To explore the effects of modified Yishen Tongluo Decoction on scores of traditional Chinese medicine syndrome,renal function,urinary microalbumin,podocalyxin and plasminogen activator inhibitor-1(PAI-1)in patients with diabetic nephropathy.Methods A total of 80 patients with diabetic nephropathy admitted to the hospital were were divided into Yishen Tongluo group and control group according to simple random method,with 40 cases in each group.The control group was treated with routine Western medicine,while the Yishen Tongluo group was additionally treated with modified Yishen Tongluo Decoction.Patients in both groups were compared in terms of incidence of adverse reactions,scores of traditional Chinese medicine syndrome,renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN)],urinary microalbumin,podocalyxin,and PAI-1.Results Compared with before treatment,the scores of turbid urine,shortness of breath and laziness to speak,lumbago,dizziness and dreaminess,frequency of urination and polyuria,feverishness in palms and soles in the two groups were all reduced after treatment,and the difference was statistically significant(P<0.05).After treatment,the scores of turbid urine,shortness of breath and laziness to speak,lumbago,dizziness and dreaminess,frequency of urination and polyuria,feverishness in palms and soles in the Yishen Tongluo group were lower than those of the control group,and the difference was statistically significant(P<0.05).Before treatment,the levels of Scr and BUN levels of patients in the Yishen Tongluo group were(213.63±8.61)μmol/L and(20.96±2.64)mmol/L,while those in the control group were(214.21±8.49)μmol/L and(21.16±2.41)mmol/L.After treatment,the levels of Scr and BUN levels in the Yishen Tongluo group were(88.61±5.45)μmol/L and(11.36±2.64)mmol/L,while those in the control group were(98.64±5.14)μmol/L and(15.64±2.68)mmol/L.Compared with before treatment,the levels of Scr and BUN in both groups of patients decreased after treatment,and the difference was st

关 键 词：益肾通络方加减 糖尿病肾病 中医证候积分 肾功能 足糖萼蛋白 尿微量白蛋白 

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