海南医科大学学报

目的:观察温阳降浊通络法中药治疗阴阳两虚兼血瘀证糖尿病肾病患者的临床疗效及其对血清炎症因子的影响。方法:将76例阴阳两虚兼血瘀证糖尿病肾病患者随机分为观察组和对照组,每组各38例。对照组给予控制体质量、控制血糖、控制血压、纠正脂代谢紊乱等西医常规治疗,观察组则在西医常规治疗基础上加服温阳降浊通络法中药,两组疗程均为1个月。观察两组治疗前后中医证候积分、肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、尿微量白蛋白(MALB)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、血液流变学指标[血浆黏度(PV)、血小板聚集率(PAR)、纤维蛋白原(FIB)]、胱抑素-C(Cys-C)、C反应蛋白(CRP)的变化情况。结果:治疗后,观察组的临床疗效明显优于对照组(P<0.05),两组中医证候积分、肾功能指标(Scr、BUN、UAER)、糖代谢指标(FPG、2 hPG、HbAlc)、血液流变学指标(PV、PAR、FIB)、Cys-C、CRP均较治疗前明显下降,差异具有统计学意义(P<0.05);且观察组上述各项指标的下降作用明显优于对照组,差异具有统计学意义(P<0.05)。结论:温阳降浊通络法中药治疗阴阳两虚兼血瘀证糖尿病肾病患者,具有较好临床疗效,可有效改善临床症状、糖代谢、肾功能以及微循环障碍,其机制可能与减轻微炎症状态有关。

Objective: To observe the clinical efficacy of compound of "warming yang, descending turbidity and dredging collaterals" in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome. Methods: Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into the observation group and the control group, with thirty-eight cases in each group. The control group was given conventional western medicine treatment, while the observation group took compound of "warming yang, descending turbidity and dredging collaterals" orally on the basis of conventional western medicine treatment. The course of treatment covered for one month. Before and after the treatment, we observed the scores of traditional Chinese medicine symptoms, indicators of renal function [serum creatinine(Scr), blood urea nitrogen(BUN), microalbuminuria(MALB)], indicators of glucose metabolism [fasting plasma glucose(FPG), 2-hour postprandial blood glucose(2 hPG), glycosylated hemoglobin(HbAlc)], indicators of hemorheology[plasma viscosity(PV), platelet aggregation rate(PAR), fibrinogen(FIB)], Cystatin-C(Cys-C), C-reactive protein(CRP) in the two groups. Results: After treatment, the clinical effect of the observation group was significantly better than the control group(P<0.05). The scores of traditional Chinese medicine symptoms, indicators of renal function(Scr, BUN, UAER), indicators of glucose metabolism(FPG, 2 hPG, HbAlc), indicators of hemorheology(PV, PAR, FIB), Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05), and the decrease in the observation group was superior to that in the control group(P<0.05). Conclusion: Compound of "warming yang, descending turbidity and dredging collaterals" has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms, glucose metabolism, renal function and microcirculatory disturbance, and the mechanism related to alleviation of micro-inflammation.