摘要
目的观察益肾泄浊方联合缬沙坦治疗糖尿病肾病的临床疗效。方法将68例糖尿病肾病患者随机分为对照组和治疗组,每组34例。对照组予基础治疗加缬沙坦口服,治疗组在对照组基础上加用益肾泄浊方。两组疗程均为12周,观察两组临床疗效,比较中医证候积分、血肌酐、肾小球滤过率、尿微量白蛋白、纤维蛋白原、D-二聚体水平的变化情况。结果①试验期间脱落及剔除8例,最终纳入统计60例,其中对照组31例、治疗组29例。②治疗组、对照组临床总有效率分别为86.2%和71.0%;组间临床疗效比较,治疗组优于对照组(P<0.05)。③治疗前后组内比较,两组中医证候积分均明显降低(P<0.05);组间治疗后比较,治疗组中医证候积分明显低于对照组(P<0.05)。④治疗前后组内比较,两组血肌酐、尿微量白蛋白水平明显降低,肾小球滤过率明显升高(P<0.05);组间治疗后比较,治疗组血肌酐、肾小球率过滤、尿微量白蛋白均较对照组明显改善(P<0.05)。⑤治疗前后组内比较,治疗组纤维蛋白原、D-二聚体水平均明显下降(P<0.05),对照组纤维蛋白原、D-二聚体无明显变化(P>0.05);组间治疗后比较,治疗组纤维蛋白原、D-二聚体水平均明显低于对照组(P<0.05)。结论益肾泄浊方联合缬沙坦治疗糖尿病肾病的临床疗效优于单用缬沙坦,能有效降低患者的尿蛋白,改善肾脏微循环及肾功能,同时能有效缓解患者的临床症状。
Objective To observe the clinical effect of Yishen Xiezhuo(kidney-supplementing, turbidity-discharging and stasis-dissolving) decoction on diabetic kidney disease(DKD). Methods Randomly divide 68 cases of DKD into the control group and the treatment group with 34 cases each. The control group was treated with routine medication plus valsartan, and the treatment group was given Yishen Xiezhuo(kidney-supplementing, turbidity-discharging and stasis-dissolving) decoction along with the treatment in the control group. The course of treatment in both groups was 12 weeks. The clinical effect, TCM pattern score, as well as the level changes of serum creatinine(Scr), estimated glomerular filtration rate(eGFR), microalbuminuria(MA), fibrinogen(Fbg) and D-Dimer(D-Di) were observed. Results ①There were 60 cases in the final statistical analysis including 31 cases in the control group and 29 cases in the treatment group as 8 cases were excluded during the clinical observation. ②The clinical effective rate of the treatment group and the control group were 86.2% and 71.0% respectively;the clinical effect of the treatment group was better than that of the control group(P<0.05). ③TCM pattern scores in the two groups both decreased significantly after treatment(P<0.05);TCM pattern scores in the treatment group were lower than those in the control group(P<0.05). ④The levels of Scr and MA in the two groups decreased while the levels of eGFR increased after treatment(P<0.05);and the improvement in the treatment group was more significant compared to that of the control group according to the levels of Scr, eGFR and MA after treatment(P<0.05). ⑤The levels of Fbg and D-Di in the treatment group decreased significantly after treatment(P<0.05), but there was no obvious change of the levels of Fbg and D-Di in the control group(P>0.05);The levels of Fbg and D-Di in the treatment group was lower than those in the control group(P<0.05). Conclusion The clinical effect of Yishen Xiezhuo(kidney-supplementing, turbidity-discharging and stasis-dissolving) decoction combined with valsartan is better than that of valsartan alone in the treatment of DKD as together they can effectively reduce the urinary protein, control the coagulation disorder and improve the renal microcirculation and renal function,as well as alleviate clinical symptoms for patients with DKD.
作者
王宪赟
黄芳
王怡
WANG Xianyun;HUANG Fang;WANG Yi(Department of Nephrology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《上海中医药杂志》
2019年第12期42-45,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市卫计委进一步加快中医药事业发展三年行动计划建设项目[ZY(2018-2020)-FWTX-4027)]
上海市卫计委科研课题(20164Y0138)
关键词
糖尿病肾病
益肾泄浊方
纤维蛋白原
D-二聚体
临床观察
diabetic kidney disease(DKD)
Yishen Xiezhuo(kidney-supplementing,turbidity-discharging and stasis-dissolving) decoction
fibrinogen
D-Dimer
clinical observation
