摘要
目的探讨补脾益肾通络方对G1A2期糖尿病肾病(diabetic kidney disease,DKD)患者的临床疗效。方法选取2019年12月—2021年11月在辽宁中医药大学附属医院内分泌科门诊或住院的DKD患者共106例,按随机数字表法分为对照组与观察组各53例。对照组予西医常规治疗,观察组在对照组基础上联合补脾益肾通络方口服,共12周。比较两组患者治疗后有效率、治疗前后尿白蛋白/尿肌酐(urinary albumin/urinary creatinine,UACR)、α1微球蛋白(α1-microglobulin,α1-MG)、β2-微球蛋白(β2-microglobulin,β2-MG)、N-乙酰-β-D氨基葡萄糖苷酶(N-acetyl-β-D glucosaminidase,NAG)、视黄醇结合蛋白(retinol-binding protein,RBP)、肾功能、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)及安全性指标。结果两组患者治疗前所有指标均具有可比性;观察组总有效率82.69%(43/52),优于对照组的68.62%(35/51),差异有统计学意义(P<0.05);与治疗前比较,两组患者治疗后UACR、α1-MG、β2-MG、NAG、RBP水平显著下降(均P<0.01)。与对照组比较,观察组治疗后UACR、β2-MG、NAG、RBP水平下降(P<0.05);两组患者治疗前后肾功能无明显变化;与治疗前比较,两组治疗后HbA1c、FBG,2 h PBG水平均下降(均P<0.01)。与对照组比较,观察组HbA1c、FBG水平下调(P<0.05);与治疗前比较,两组患者治疗后TC、TG水平显著下降(均P<0.01),LDL-C、HDL-C水平变化具有统计学意义(均P<0.05);治疗后与对照组比较,观察组TC、TG水平下降(P<0.05);两组患者安全性指标均在正常范围内,无不良反应发生。结论补脾益肾通络方治疗G1A2期DKD临床疗效显著,安全性良好,值得临床推荐。
Objective To investigate the clinical effect of Bupi Yishen Tongluo Decoction(补脾益肾通络方)on patients with G1A2 diabetic kidney disease(DKD).Methods A total of 106 outpatients or inpatients with DKD in the Department of Endocrinology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December 2019 to November 2021 were selected and divided into control group and observation group according to the random number table method,with 53 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Bupi Yishen Tongluo Decoction orally on the basis of the control group for 12 weeks.The effective rate after treatment,the levels of urinary albumin/urinary creatinine(UACR),α1-microglobulin(α1-MG),β2-microglobulin(β2-MG),N-acetyl-β-D glucosaminidase(NAG),retinol-binding protein(RBP),renal function,glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and safety indexes were compared between the two groups before and after treatment.Results All the indexes were comparable between the two groups before treatment.The total effective rate of the observation group was 82.69%(43/52),which was better than 68.62%(35/51)of the control group,and the difference was statistically significant(P<0.05).Compared with those before treatment,the levels of UACR,α1-MG,β2-MG,NAG and RBP in the two groups were significantly decreased after treatment(all P<0.01).Compared with those in the control group,the levels of UACR,β2-MG,NAG and RBP in the observation group were decreased after treatment(P<0.05).There was no significant change in renal function in the two groups before and after treatment.Compared with those before treatment,the levels of HbA1c,FBG and 2 h PBG in the two groups were decreased after treatment(all P<0.01).Compared with those in the control group,the levels of HbA1c and FBG in the observation group were down-regulated(P<0.05).Compared with those before treatment,the levels of TC and TG in the two groups were significantly decreased after treatment(all P<0.05),and the levels of LDL-C and HDL-C were significantly changed(all P<0.05).After treatment,compared with those of the control group,the levels of TC and TG in the observation group were decreased(P<0.05).The safety indexes of the two groups were within the normal range,and no adverse reactions occurred.Conclusion Bupi Yishen Tongluo Decoction is effective and safe in the treatment of G1A2 stage DKD,which is worthy of clinical recommendation.
作者
臧春雪
高艺铭
高天舒
ZANG Chunxue;GAO Yiming;GAO Tianshu(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110033,Liaoning,China;China Medical University,First Clinical College,Shenyang 110122,Liaoning,China)
出处
《辽宁中医杂志》
CAS
北大核心
2024年第9期45-48,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家重点研发计划项目(2017YFC1700501)
北京医卫健康公益基金会项目(YWJKJJHKYJJ-KH2019004)
沈阳市临床医学研究中心项目(沈科[2018]75号-5)。
关键词
糖尿病肾病
G1A2期
临床研究
补脾益肾通络方
diabetic nephropathy
G1A2 stage
clinical research
Bupi Yishen Tongluo Decoction(补脾益肾通络方)
