益气滋阴活血泄浊法治疗糖尿病肾病慢性肾衰竭疗效观察
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摘要
目的观察益气滋阴活血泄浊法治疗糖尿病肾病慢性肾衰竭的临床疗效。方法将60例糖尿病肾病慢性肾衰竭患者随机分为对照组与治疗组,每组30例。对照组采用西医常规治疗,治疗组在对照组治疗基础上采用益气滋阴活血泄浊法治疗,2组疗程均为28 d。观察2组治疗前后肾功能指标[血肌酐(SCr)、尿素氮(BUN)、尿酸(UA)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血浆黏度、纤维蛋白原水平和主要中医症状评分变化情况,统计2组临床疗效。结果治疗后,治疗组SCr、BUN、UA、TC、TG、LDL-C、血浆黏度、纤维蛋白原水平和中医症状评分与治疗前比较均明显降低(P均<0.05),HDL-C水平与治疗前比较差异无统计学意义(P>0.05);对照组SCr、BUN、UA、TC、TG、HDL-C、LDL-C、血浆黏度、纤维蛋白原水平与治疗前比较差异均无统计学意义(P均>0.05),中医症状评分与治疗前比较明显降低(P<0.05);治疗组治疗后SCr、BUN、TC、TG、LDL-C、血浆黏度、纤维蛋白原水平和中医症状评分均明显低于对照组(P均<0.05),UA、HDL-C水平与对照组比较差异均无统计学意义(P均>0.05);治疗组总有效率明显高于对照组(P<0.05)。结论益气滋阴活血泄浊法治疗糖尿病肾病慢性肾衰竭能够明显改善肾功能、血液流变学异常、脂代谢紊乱及临床症状,提高临床疗效。
Objective It is to observe the clinical therapeutic effect of therapy with replenishing Qi and enriching Yin, activating blood and purging turbid on chronic renal failure with diabetic nephropathy. Methods 60 patients with chronic renal failure with diabetic nephropathy were randomly divided into control group and treatment group, 30 cases in each group. The control group was treated with conventional western medicine. The treatment group was treated with the drugs for replenishing Qi and enriching Yin, activating blood and purging turbidon the basis of the control group.Both the courses of treatments were 28 days. The changes of renal function indexes [serum creatinine(SCr), urea nitrogen(BUN), uric acid(UA)], blood lipid index [total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C)], plasma viscosity, fibrinogen and major TCM symptom scores before and after treatment were observed, and the clinical efficacy of the two groups were statistically analyzed. Results After treatment, the levels of SCr, BUN, UA, TC, TG, LDL-C, plasma viscosity, fibrinogen and TCM symptom scores of the treatment group were significantly lower than those before treatment(P<0.05), the difference in HDL-C level was not significant compared with that before treatment(P>0.05). There was no statistical difference in SCr, BUN, UA, TC, TG, HDL-C, LDL-C, plasma viscosity and fibrinogen between that before and ater treatment in the control group(P>0.05), but TCM symptom scores were significantly lower than that before treatment(P<0.05). The levels of SCr, BUN, TC, TG, LDL-C, plasma viscosity, fibrinogen and TCM symptoms after treatment in the treatment group were significantly lower than the control group(P<0.05), but there was no significant difference in the UA and HDL-C levels between the two groups(P>0.05). The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05). Conclusion The drugs for replenishing Qi and enriching Yin, activating blood and purging turbidon can significantly improve renal function, hemorheology abnormalities, lipid metabolism disorders and clinical symptoms, and improve clinical efficacy in the treatment of chronic renal failure with diabetic nephropathy.
Objective It is to observe the clinical therapeutic effect of therapy with replenishing Qi and enriching Yin, activating blood and purging turbid on chronic renal failure with diabetic nephropathy. Methods 60 patients with chronic renal failure with diabetic nephropathy were randomly divided into control group and treatment group, 30 cases in each group. The control group was treated with conventional western medicine. The treatment group was treated with the drugs for replenishing Qi and enriching Yin, activating blood and purging turbidon the basis of the control group.Both the courses of treatments were 28 days. The changes of renal function indexes [serum creatinine(SCr), urea nitrogen(BUN), uric acid(UA)], blood lipid index [total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C)], plasma viscosity, fibrinogen and major TCM symptom scores before and after treatment were observed, and the clinical efficacy of the two groups were statistically analyzed. Results After treatment, the levels of SCr, BUN, UA, TC, TG, LDL-C, plasma viscosity, fibrinogen and TCM symptom scores of the treatment group were significantly lower than those before treatment(P<0.05), the difference in HDL-C level was not significant compared with that before treatment(P>0.05). There was no statistical difference in SCr, BUN, UA, TC, TG, HDL-C, LDL-C, plasma viscosity and fibrinogen between that before and ater treatment in the control group(P>0.05), but TCM symptom scores were significantly lower than that before treatment(P<0.05). The levels of SCr, BUN, TC, TG, LDL-C, plasma viscosity, fibrinogen and TCM symptoms after treatment in the treatment group were significantly lower than the control group(P<0.05), but there was no significant difference in the UA and HDL-C levels between the two groups(P>0.05). The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05). Conclusion The drugs for replenishing Qi and enriching Yin, activating blood and purging turbidon can significantly improve renal function, hemorheology abnormalities, lipid metabolism disorders and clinical symptoms, and improve clinical efficacy in the treatment of chronic renal failure with diabetic nephropathy.
引文
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[10] 余翠,熊钱颖,王李卓,等.糖尿病肾病的发病机制及治疗进展[J].医学综述,2015,21(21):3944-3947
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[12] 娄志杰,韩向莉,邵岩,等.糖尿病肾病中医病因病机及中医药内、外治疗研究新进展[J].医学理论与实践,2017,30(6):808-810
[13] 尤良震,林逸轩,方朝晖,等.黄芪甲苷治疗糖尿病肾病及其并发症药理作用研究进展[J].中国中药杂志,2017,42(24):4700-4706
[14] 郑素玉,陈健.巴戟天有效成分及其药理作用实验研究进展[J].世界中西医结合杂志,2012,7(9):823-825;828
[15] 高兵.丹参的药理作用及临床应用分析[J].中国现代药物应用,2018,12(1):196-197
[16] 胡云飞,徐国兵.牡丹皮及其主要成分丹皮酚的药理作用研究进展[J].安徽医药,2014,18(4):589-592
[17] 宋侠.大黄的药理及其在肾脏病中的运用[J].中国现代药物应用,2017,11(13):191-192
[18] 杨炀,税丕先,陈滟,等.中药大黄在临床应用中的功效以及对其药理作用[J].基因组学与应用生物学,2017,36(3):1226-1231
[2] 郑宇.血液透析治疗糖尿病肾病终末期疗效和并发症分析[J].当代医学,2018,24(6):15-17
[3] 贾慧霞.血液透析急性并发症的病因及处理[J].中国实用医药,2015,10(36):97-98
[4] 周全,李海霞,王丽,等.益气养阴活血汤对早期糖尿病肾病患者血清IL-17A、IL-18、TNF-α的影响[J].中药材,2018,41(2):473-475
[5] 王彤雪,刘怀珍.清肾汤联合缬沙坦治疗早期糖尿病肾病临床研究[J].中医药临床杂志,2018,30(2):321-323
[6] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,22(8):6-8
[7] 中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中华糖尿病杂志,2014,6(11):792-801
[8] 国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:163-168
[9] Duran-Salgado MB,Rubio-Guerra AF.Diabetic nephropathy and inflammation[J].World J Diabetes,2014,5(3):393-398
[10] 余翠,熊钱颖,王李卓,等.糖尿病肾病的发病机制及治疗进展[J].医学综述,2015,21(21):3944-3947
[11] 江旭锋,曾庆春,黄岑汉,等.糖尿病肾病中医病因病机探要[J].河南中医,2016,36(5):924-926
[12] 娄志杰,韩向莉,邵岩,等.糖尿病肾病中医病因病机及中医药内、外治疗研究新进展[J].医学理论与实践,2017,30(6):808-810
[13] 尤良震,林逸轩,方朝晖,等.黄芪甲苷治疗糖尿病肾病及其并发症药理作用研究进展[J].中国中药杂志,2017,42(24):4700-4706
[14] 郑素玉,陈健.巴戟天有效成分及其药理作用实验研究进展[J].世界中西医结合杂志,2012,7(9):823-825;828
[15] 高兵.丹参的药理作用及临床应用分析[J].中国现代药物应用,2018,12(1):196-197
[16] 胡云飞,徐国兵.牡丹皮及其主要成分丹皮酚的药理作用研究进展[J].安徽医药,2014,18(4):589-592
[17] 宋侠.大黄的药理及其在肾脏病中的运用[J].中国现代药物应用,2017,11(13):191-192
[18] 杨炀,税丕先,陈滟,等.中药大黄在临床应用中的功效以及对其药理作用[J].基因组学与应用生物学,2017,36(3):1226-1231