加味陈氏糖肾方治疗糖尿病肾脏病G3-4A1-3期合并脂代谢紊乱临床研究  

Clinical study of modified CHEN’s Tangshen decoction in the treatment of diabetic kidney disease G3-4A1-3 complicated with lipid metabolism disorder

作　　者：盛凌黎[1,2] 曹子怡 郭小平 李文诗 孙家乐 王琳 SHENG Lingli;CAO Ziyi;GUO Xiaoping;LI Wenshi;SUN Jiale;WANG Lin(Nephropathy DepartmentⅡ,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Faculty of Chinese Medicine,Macao University of Science and Technology,Macao 999078,China;The First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]上海中医药大学附属龙华医院肾病二科,上海200032 [2]澳门科技大学中医药学院,中国澳门999078 [3]陕西中医药大学第一临床医学院,陕西咸阳712046

出　　处：《陕西中医》2025年第2期192-196,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会卫生行业临床研究专项立项课题(202140371)。

摘　　要：目的:观察加味陈氏糖肾方治疗糖尿病肾脏病G3-4A1-3期合并脂代谢紊乱的临床疗效。方法:共纳入72例糖尿病肾脏病G3-4A1-3期合并脂代谢紊乱的患者,在西医常规疗法基础上,对照组35例患者给予安慰剂治疗,观察组37例患者给予加味陈氏糖肾方治疗,比较两组患者血糖、肾功能、血脂、尿蛋白指标及中医症候积分、临床综合疗效,采用Pearson相关分析探讨血脂水平与24 h尿蛋白的相关性。结果:治疗前两组患者各项指标均未见统计学差异(P>0.05)。治疗后,观察组患者空腹血糖(FBG)、血肌酐(Scr)及血尿素氮(BUN)水平,血清甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白(LDL-C)水平,24 h尿蛋白、尿微量白蛋白浓度、尿α1微球蛋白及尿β2微球蛋白水平,中医症候积分均明显低于对照组(P<0.05);血清高密度脂蛋白(HDL-C)水平明显高于对照组(P<0.05)。Pearson相关分析显示,TC、LDL-C均与24 h尿蛋白呈正相关(P<0.05)。观察组患者临床综合疗效总有效率为83.78%,明显高于对照组患者的60.00%(P<0.05)。结论:加味陈氏糖肾方能够有效降低糖尿病肾脏病G3-4A1-3期合并脂代谢紊乱患者尿蛋白水平,稳定患者肾功能,调节血糖水平和脂代谢紊乱,进而延缓糖尿病肾脏病进展。Objective:To observe the clinical effect of modified CHEN’s Tangshen decoction in the treatment of diabetic kidney disease G3-4A1-3 stage complicated with lipid metabolism disorder.Methods:This prospective included 72 patients with G3-4A1-3 stage diabetic kidney disease complicated with lipid metabolism disorder.On the basis of the standard therapy,35 patients in the control group were given placebo treatment,and 37 patients in the observation group were given the modified CHEN’s Tangshen decoction treatment.Blood glucose,renal function,blood lipid,urinary protein indexes,TCM symptom score and clinical comprehensive effect were compared between the two groups.Pearson analysis was used to explore the correlation between blood lipid level and 24 h urinary protein.Results:Before treatment,there were no obvious differences in all indexes between the two groups(P>0.05).After treatment,compare with the control group,the levels of fasting blood glucose(FBG),serum creatinine(Scr)and blood urea nitrogen(BUN),serum triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL-C),24 h urinary protein,urinary microalbumin concentration,urinaryα1 microglobulin and urinaryβ2 microglobulin,and TCM syndrome score in the observation group were obviously lower(P<0.05),and the serum high density lipoprotein(HDL-C)level was obviously higher(P<0.05).TC and LDL-C were positively correlated with 24 h urinary protein(P<0.05).The total effective rate in the observation group was 83.78%,which was obviously higher than 60.00%in the control group(P<0.05).Conclusion:Modified CHEN’s Tangshen decoction can effectively reduce the urinary protein level of patients with G3-4A1-3 stage diabetic kidney disease complicated with lipid metabolism disorder,stabilize renal function,regulate blood glucose level and lipid metabolism disorder,and then delay the progression of diabetic kidney disease.

关 键 词：糖尿病肾脏病 脂代谢紊乱 加味陈氏糖肾方 肾功能 尿蛋白 中医症候积分 

分 类 号：R587.1[医药卫生—内分泌]