补阳活络肾宁饮联合西医基础疗法治疗Mogensen分期Ⅲ~Ⅳ期糖尿病肾病患者的疗效及对肾功能的影响  

Efficacy of Buyang Huoluo Shenning Decoction combined with western medicine basic therapy in the treatment of patients with Mogensen stage Ⅲ-Ⅳ diabetic nephropathy and its effect on renal function

作　　者：陈文芃 魏丹蕾 林春挺 杨晓晴 CHEN Wen-peng;WEI Dan-lei;LIN Chun-ting(Department of Geriatrics,Guangzhou Hospital of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510000,China;Department of Endocrinology,Guangzhou Hospital of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510000,China)

机构地区：[1]广州中医药大学附属广州中医院老年病科,广东广州510000 [2]广州中医药大学附属广州中医院内分泌科,广东广州510000 [3]广州市番禺区石碁镇社区卫生服务中心中医科,广东广州510000

出　　处：《临床和实验医学杂志》2025年第1期33-38,共6页Journal of Clinical and Experimental Medicine

基　　金：广东省科技计划项目(编号:2020W00168)。

摘　　要：目的探讨中医方剂补阳活络肾宁饮联合西医基础疗法治疗Mogensen分期Ⅲ~Ⅳ期糖尿病肾病(DN)患者的疗效及对肾功能的影响。方法前瞻性选取2021年5月至2022年6月广州中医药大学附属广州中医院收治的137例Mogensen分期为Ⅲ~Ⅳ期DN患者,按照随机数字表法将其分为中西医组(n=69)、西医组(n=68)。西医组患者主要采用西医药物进行治疗,中西医组患者在西医组患者基础上加用补阳活络肾宁饮治疗,两组疗程均为6个月。观察两组患者的临床疗效,比较两组患者治疗前、治疗6个月后的肾功能指标[24 h尿蛋白定量、血肌酐、尿白蛋白/肌酐(ACR)]、中医证候积分、肾功能损伤相关因子[Podocin、Nephrin、α-平滑肌肌动蛋白(α-SMA)、内皮素-1(ET-1)、血管性血友病因子(vWF)、肾损伤分子-1(KIM-1)],并比较两组患者治疗期间的不良反应发生情况。结果经过6个月治疗,中西医组临床疗效优于西医组,差异有统计学意义(P<0.05)。治疗6个月后,两组患者的24 h尿蛋白定量、血肌酐、ACR均较治疗前明显降低,且中西医组患者的24 h尿蛋白定量、血肌酐、ACR分别为(154.6±19.4)μg/min、(101.3±12.6)μmol/L、(445.8±65.0)mg/g,均低于西医组[(170.3±23.6)μg/min、(107.8±14.2)μmol/L、(489.8±73.0)mg/g],差异均有统计学意义(P<0.05)。治疗6个月后,两组患者的中医证候积分均较治疗前明显降低,且中西医组患者的主证积分、次证积分、总分分别为(7.31±1.55)、(2.74±0.64)、(10.05±1.78)分,均低于西医组[(8.65±1.82)、(3.13±0.76)、(11.78±2.41)分],差异均有统计学意义(P<0.05)。治疗6个月后,两组患者的Podocin、Nephrin、α-SMA、ET-1、vWF、KIM-1水平均较治疗前明显降低,且中西医组患者的Podocin、Nephrin、α-SMA、ET-1、vWF、KIM-1水平均低于西医组,差异均有统计学意义(P<0.05)。中西医组的总不良反应发生率与西医组比较,差异无统计学意义(P>0.05)。结论中医方�Objective To explore the efficacy of Buyang Huoluo Shenning Decoction combined with western medicine basic therapy in the treatment of patients with Mogensen stageⅢ-Ⅳdiabetic nephropathy(DN)and its effect on renal function.Methods A total of 137 patients with Mogensen stageⅢ-ⅣDN admitted to Guangzhou Hospital of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine from May 2021 to June 2022 were prospectively selected and divided into the Chinese and Western medicine group(n=69)and the Western medicine group(n=68)according to the random number table method.The patients in the Western medicine group primarily received treatment with Western medical medications.In contrast,the patients in the Chinese and Western medicine group were further administered with Buyang Huoluo Shenning Decoction in addition to the treatment regimen of the Western medicine group.The entire treatment duration lasted for 6 months.The clinical efficacy of the two groups was observed.The renal function indexes[24 h urinary total protein,creatinine,urinary albumin/creatinine(ACR)],traditional Chinese medicine syndrome scores,renal function injury related factors[Podocin,Nephrin,α-smooth muscle actin(α-SMA),endothelin-1(ET-1),von Willebrand factor(vWF),kidney injury molecule-1(KIM-1)]before treatment and after 6 months of treatment were compared between the two groups.The incidence of adverse reactions during treatment was compared between the two groups.Results After 6 months of treatment,the clinical efficacy of the Chinese and Western medicine group was better than that of the Western medicine group,and the difference was statistically significant(P<0.05).After 6 months of treatment,the 24 h urinary total protein,serum creatinine and ACR of the two groups were significantly decreased before treatment,and the 24 h urinary total protein,serum creatinine and ACR of the Chinese and Western medicine group were(154.6±19.4)μg/min,(101.3±12.6)μmol/L and(445.8±65.0)mg/g,respectively,which were lower than those of the W

关 键 词：2型糖尿病 糖尿病肾病 补阳活络肾宁饮 Mogensen分期 肾功能 

分 类 号：R692.9[医药卫生—泌尿科学] R587.2[医药卫生—外科学]