益肾活血方治疗Ⅲ期糖尿病肾病患者有效性的研究  

Effect of integrated Traditional Chinese and Western Medicine on stageⅢdiabetic kidney disease

作　　者：赵晓燕 行延霞 王政丽 李雯圆 李红 Zhao Xiaoyan;Hang Yanxia;Wang Zhengli;Li Wenyuan;Li Hong(Department of the Second Nephropathy,Affiliated Hospital of Integrated Chinese and Western Medicine of Shanxi University of Traditional Chinese Medicine,Taiyuan 030000,China)

机构地区：[1]山西中医药大学附属中西医结合医院肾病二科,太原030000

出　　处：《山西医药杂志》2025年第2期83-87,共5页Shanxi Medical Journal

基　　金：山西省中医药管理局科研课题项目(2023ZYYDA2034);山西省第五批中青年中医临床优秀骨干人才(晋卫中医药函[2023]14号);山西省卫健委“中医药传承防治慢性肾脏病”创新团队重点项目(ZYYTD2024015)。

摘　　要：目的探究中西医结合治疗Ⅲ期糖尿病肾病的疗效及其对血清炎症指标的影响。方法选择2023年8月至2024年3月在山西中医药大学附属中西医结合医院肾病科就诊的Ⅲ期糖尿病肾病患者为研究对象,随机分组法分为治疗组、对照组各30例。其中对照组应用常规治疗,而治疗组则是在常规治疗基础上加用益肾活血方,观察血清肌酐(Scr)、尿微量白蛋白、24 h尿蛋白定量、空腹血糖、餐后2 h血糖、胱抑素C(Cys-C)等疗效指标及单核细胞趋化蛋白-1(MCP-1)炎症指标。结果2组治疗糖尿病肾病肌酐、尿素氮等指标差异无统计学意义,但治疗组具有更好的趋势,下降幅度明显。结论益肾活血方联合常规降糖降压药,治疗早期气阴两虚型糖尿病肾病患者能够显著改善患者蛋白尿和血MCP-1,提示益肾活血方协同科素亚治疗糖尿病肾病的作用机制可能通过抑制MCP-1的表达而发挥抗肾脏纤维化的作用。Objective To explore the therapeutic effect of integrated traditional Chinese and Western medicine on stageⅢdiabetic kidney disease(DKD)and its effect on serum inflammatory indexes.Methods Patients with stageⅢDKD who were enrolled in the Department of the Second of Nephropathy,Affiliated Hospital of Integrated Chinese and Western Medicine of Shanxi University of Traditional Chinese Medicine from August 2023 to March 2024 were selected as the research subjects and randomly divided into groups with an equal ratio of men and women,including 30 cases in each group and 30 cases in the treatment group.The control group was treated with conventional Western medicine,and the treatment group was additionally treated with invigorating the kidney and improving blood circulation decoction on the basis of the control group.The curative effect indexes,including serum creatinine(SCR),urinary microalbumin,24-hour urinary protein quantification,fasting blood glucose(FBG),2h postprandial blood glucose,cysteine(Cys)C and inflammatory indexes(MCP-1)were observed.Results There was no statistical difference between the two groups in the treatment of diabetic nephropathy,but the treatment group had a better trend.Conclusion Invigorating the kidney and improving blood circulation decoction combined with conventional hypoglycemic and hypertensive drugs in the treatment of DKD patients with early Qi-Yin deficiency can significantly improve proteinuria and blood MCP-1,suggesting that the mechanism of invigorating the kidney and improving blood circulation decoction combined with standard Western medicine may have anti-renal fibrosis effect by inhibiting the expression of MCP-1.

关 键 词：糖尿病肾病 益肾活血方 炎症 趋化因子CCL2 

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