消渴益肾汤联合缬沙坦片治疗脾肾气虚夹瘀证2 型糖尿病肾病临床研究
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Clinical Study on Xiaoke Yishen Decoction Combined with Valsartan Tablets for Type 2 Diabetic Nephropathy with Syndrome of Spleen- Kidney Qi Deficiency Complicated with Stasis
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    摘要:

    目的:观察消渴益肾汤联合缬沙坦片治疗脾肾气虚夹瘀证2 型糖尿病肾病(DN) Ⅲ期患者的临床 疗效及对血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、超敏C-反应蛋白(hs-CRP) 水平的影响。方 法:选择脾肾气虚夹瘀证2 型DN(Ⅲ期) 患者82 例,按随机数字表法分为对照组与治疗组各41 例。在DN 常规治疗的基础上,对照组加用缬沙坦片治疗;治疗组在对照组基础上加用消渴益肾汤治疗。2 组均治疗 12 周。比较2 组临床疗效、肾功能、中医证候评分及炎症因子IL-6、TNF-α、hs-CRP 水平。结果:治疗组 总有效率为92.68%,对照组为68.30%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组24 h 尿蛋白 定量、尿白蛋白/肌酐比、血尿素氮、血肌酐水平均较治疗前降低(P<0.05),且治疗组上述各项指标均低于 对照组(P<0.05)。治疗后,2 组小便频数、纳呆、疲乏、肢体麻痛、胸痹心痛、唇紫暗、面色苍白、腰膝 酸、肢体浮肿等中医证候评分均较治疗前降低(P<0.05),且治疗组上述各项评分均低于对照组(P<0.05)。 治疗后,2 组血清IL-6、TNF-α、hs-CRP 水平均较治疗前降低(P<0.05),且治疗组上述各项指标均低于对照 组(P<0.05)。结论:消渴益肾汤联合缬沙坦片治疗脾肾气虚夹瘀证2 型DN(Ⅲ期) 可提高临床疗效,有效抑 制机体炎症反应,从而改善患者肾功能和中医证候。

    Abstract:

    Abstract: Objective: To observe the clinical effect of the therapy of Xiaoke Yishen Decoction combined with Valsartan Tablets on the levels of serum interleukin (IL- 6),tumor necrosis factor (TNF)- α and hypersensitive C-reactive protein (hs-CRP) in patients with type 2 diabetic nephropathy (DN) stageⅢ with syndrome of spleen-kidney qi deficiency complicated with stasis. Methods:A total of 82 patients with type 2 DN (stage Ⅲ) with syndrome of spleen-kidney qi deficiency complicated with stasis were selected and divided into the control group and the treatment group according to random number table method, with 41 cases in each group. On the basis of routine treatment of DN,the control group was additionally treated with Valsartan Tablets;the treatment group was additionally treated with Xiaoke Yishen Decoction based on the treatment of the control group. Both groups were treated for 12 weeks. The clinical effects, kidney function, traditional Chinese medicine (TCM) syndrome scores and levels of inflammatory factors (IL-6,TNF-α and hs-CRP) were compared between the two groups. Results:The total effective rate was 92.68% in the treatment group and 68.30% in the control group,the difference being significant (P<0.05). After treatment,the 24-hour urinary protein quantity,urinary albumin/creatinine ratio,blood urea nitrogen and blood creatinine levels in the two groups were decreased when compared with those before treatment (P<0.05),and the above indexes in the treatment group were lower than those in the control group (P< 0.05). After treatment, the urination frequency, poor appetite and digestion, fatigue, limbs numbness and pain, chest impediment and pain, purple and dusky tongue, pale complexion, waist and knee soreness, limbs edema and other TCM syndrome scores in the two groups were all decreased when compared with those before treatment (P<0.05),and the above scores in the treatment group were lower than those in the control group (P<0.05). After treatment,serum levels of IL- 6,TNF- α and hs- CRP in the two groups were decreased when compared with those before treatment (P<0.05), and the above indexes in the treatment group were lower than those in the control group (P<0.05). Conclusion: The therapy of Xiaoke Yishen Decoction combined with Valsartan Tablets can improve the clinical effect on DN (stage Ⅲ) with syndrome of spleen- kidney qi deficiency complicated with stasis, effectively inhibit the inflammatory responses of the mechanism,so as to improve patients' kidney function and TCM syndromes.

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应瑶,傅松维,徐嫣苓,胡蕾.消渴益肾汤联合缬沙坦片治疗脾肾气虚夹瘀证2 型糖尿病肾病临床研究[J].新中医,2023,55(12):58-62

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  • 在线发布日期: 2023-06-27
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