摘要
目的:探讨滋肾益气方联合厄贝沙坦治疗糖尿病肾病的临床疗效,并观察其对患者肾脏纤维化指标及炎症因子的影响。方法:选取112糖尿病肾病并且辨证为肾虚血瘀、气阴两虚患者,随机分为两组。对照组给予厄贝沙坦片治疗,观察组给予厄贝沙坦片联合滋肾益气方治疗,连续治疗12周。比较两组患者治疗前后肾功能损伤指标、肾脏纤维化指标、炎症因子、中医证候积分、生活质量及临床疗效,并进行统计分析。结果:观察组总有效率91.1%,对照组总有效率78.6%,两组比较有统计学意义(P<0.05)。治疗后两组的肾功能指标(24 hPro、mAlb、Scr、BUN及UAER)、肾脏纤维化指标(LN、PCⅢ、CⅣ、TGF-β_1及CTGF)及炎症因子(hs-CRP、IL-6及TNF-α)的水平均显著降低(P<0.05),并且观察组以上指标显著低于对照组,比较有统计学意义(P<0.05)。两组患者治疗后各项中医证候积分均显著降低(P<0.05),并且观察组治疗后的各项评分较对照组低(P<0.05)。两组患者躯体功能、社会功能及情绪功能的评分均明显降低(P<0.05),并且观察组的评分较对照组低(P<0.05),而两组的认知功能、角色功能评分治疗前后没有明显差异(P>0.05)。结论:滋肾益气方联合厄贝沙坦治疗糖尿病肾病可以有效改善患者肾功能,延缓肾间质纤维化、肾小球硬化,可显著抑制糖尿病肾病病情进展,疗效确切。
Objective:To investigate the clinical efficacy of Nourishing Kidney and Supplementing Qi Decoction combined with erbesartan in the treatment of diabetic nephropathyand observe the effect of it on renal fibrosis index and inflammatory factors in patients.Methods:A total of 112 diabetic nephropathy patients with kidney deficiency,blood stasis and Qi Yin deficiency were randomly divided into two groups.The control group was treated with Irbesartan Tabletsand the observation group was treated with Irbesartan Tablets combined with Nourishing Kidney and Supplementing Qi Decoction for 12 weeks.The index of renal function injury,renal fibrosis index,inflammatory factor,TCM syndrome score,quality of life and clinical effect were compared and analyzed statistically before and after treatment in the two groups.Results:The total effective rate of the observation group was 91.1%,and the total effective rate of the control group was 78.6%.There was a significant difference between the two groups(P<0.05).After treatment,the indexes of renal function(24 hPro,mAlb,Scr,BUN and UAER),the indexes of renal fibrosis(LN,PC III,C IV,TGF-beta 1 and CTGF)and the levels of inflammatory factors(hs-CRP,IL-6 and TNF-α)were significantly decreased,and the above indexes were significantly lower than those in the control group.The two groups were significantly lower than those in the control group(P<0.05).The scores of TCM syndromes in the two groups were significantly reduced after treatment(P<0.05),and the scores in the observation group after treatment were lower than those in the control group(P<0.05).The scores of body function,social function and emotional function of the two groups were significantly lower(P<0.05),and the score of the observation group was lower than that of the control group(P<0.05).But the cognitive function and role function score of the two groups were not significantly different before and after treatment(P>0.05).Conclusion:The treatment of diabetic nephropathy can effectively improve renal function,postpone renal interstitial fibrosis and glomerulosclerosis,which can significantly inhibit the progression of diabetic nephropathy,and the curative effect is accurate.
作者
王玲
WANG Ling(Department of Heart and Kidney,Qinghai Provincial Hospital of Traditional Chinese Medicine,Xining 810000,Qinghai,China)
出处
《中华中医药学刊》
CAS
北大核心
2019年第4期940-943,共4页
Chinese Archives of Traditional Chinese Medicine
基金
青海省科技厅自然科学基金项目(2012-Z-908)
关键词
糖尿病肾病
厄贝沙坦
肾脏纤维化
炎症反应
diabetic nephropathy
irbesartan
renal fibrosis
inflammatory response
