归芪饮治疗糖尿病肾脏病Ⅲ~Ⅳ期气虚血瘀证患者的临床疗效观察  

Clinical effect observation of Guiqi Decoction in treating diabetic kidney disease stageⅢ~Ⅳpatients with qi deficiency and blood stasis syndrome

作　　者：黄磊[1] 李桂霞 聂立秀 翟晓丽[1] 孙国华 邓再莉 黄艺 戴泽亮[1] HUANG Lei;LI Guixia;NIE Lixiu(Department of Nephrology,The Second People’s Hospital of Lanzhou,Lanzhou 730046,China)

机构地区：[1]兰州市第二人民医院肾病科,兰州730046

出　　处：《中国处方药》2025年第7期105-109,共5页Journal of China Prescription Drug

基　　金：兰州市卫生健康行业科研项目(A2023029)。

摘　　要：目的观察归芪饮治疗糖尿病肾脏病Ⅲ~Ⅳ期气虚血瘀证患者的临床疗效。方法选取2022年1月~2024年6月在兰州市第二人民医院肾病科住院治疗的符合纳入标准的患者300例,随机分为治疗组152例和对照组148例,对照组给予西医常规治疗,治疗组给予西医常规治疗+归芪饮,观察8周。比较两组治疗前后肾小球滤过率(eGFR)、血肌酐(Scr)、尿素氮(BUN)、尿白蛋白/肌酐比值(UACR)、胱抑素-C(Cys-C)、24 h尿蛋白(UTP)、尿α_(1)微球蛋白(α_(1)-MG)、尿β_(2)微球蛋白(β_(2)-MG)的变化,并评价归芪饮的临床疗效。结果治疗后,两组eGFR较治疗前升高,Scr、BUN、Cys-C、UACR、UTP、α_(1)-MG、β_(2)-MG水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组eGFR水平明显高于对照组,Scr、BUN、Cys-C、UACR、UTP、α_(1)-MG、β_(2)-MG水平明显低于对照组,差异有统计学意义(P<0.05)。两组治疗后中医证候积分下降,与治疗前比较,差异有统计学意义(P<0.05);且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。两组治疗后中医证候疗效比较,治疗组中医证候总有效率(84.21%)优于对照组(66.89%),差异有统计学意义(P<0.05)。临床综合疗效比较,治疗组总有效率为93.42%优于对照组74.32%,差异有统计学意义(P<0.05)。结论归芪饮可以改善糖尿病肾脏病Ⅲ~Ⅳ期气虚血瘀证患者的中医证候积分、肾功能,降低尿蛋白,提高临床疗效。Objective To observe the clinical effect of Guiqi Decoction in treating diabetic kidney disease stageⅢ~Ⅳpatients with qi deficiency and blood stasis syndrome.Methods Selected 300 patients who met the inclusion criteria and were hospitalized for treatment in the Department of Nephrology,the Second People's Hospital of Lanzhou from January 2022 to June 2024,randomly divided into 152 cases for the treatment group and 148 cases for the control group,the control group was treated with conventional therapy of western medicine,and the treatment group was treated with conventional therapy of western medicine and Guiqi Decoction,observations were performed for 8 weeks.The changes of glomerular filtration rate(eGFR),serum creatinine(Scr),urea nitrogen(BUN),urinary albumin/creatinine ratio(UACR),cystatin-C(Cys-C),24-hour urinary protein(UTP),Urineα_(1)-microglobulin(α_(1)-MG),urineβ_(2)-microglobulin(β_(2)-MG)were compared between the two groups before and after treatment,and the clinical efficacy of Guiqi Decoction was evaluated.Results After treatment,the eGFR of the two groups were higher than that before treatment,and the levels of Scr,BUN,Cys-C,UACR,UTP,α_(1)-MG andβ_(2)-MG were lower than those before treatment,the difference was statistically significant(P<0.05);the level of eGFR in the treatment group was significantly higher than that in the control group,and the levels of Scr,BUN,Cys-C,UACR,UTP,α_(1)-MG andβ_(2)-MG were significantly lower than those in the control group,the difference was statistically significant(P<0.05).After treatment,the TCM symptom scores decreased in the two groups,with statistical significance(P<0.05),the TCM symptom scores of the treatment group were significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Compared with the efficacy of TCM syndrome between the two groups,the total effective rate of TCM syndrome in the treatment group was 84.21%,better than that of the control group by 66.89%,with statistical significance(P<0.0

关 键 词：糖尿病肾脏病 归芪饮 气虚血瘀证 临床疗效 

分 类 号：R259[医药卫生—中西医结合]