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目的:观察益肾化瘀通络法治疗Ⅳ期糖尿病肾病(diabetic nephropathy,DN)的临床疗效。方法:将68例气阴两虚、瘀血阻络证DN患者随机分为治疗组(44例)和对照组(24例),对照组在控制饮食、运动治疗基础上给予常规西药降压、降糖治疗,治疗组患者在对照组疗法基础上口服益肾化瘀通络方。治疗后观察两组临床疗效,治疗前后分别检测两组24 h尿蛋白、尿白蛋白排泄率、空腹血糖、糖化血红蛋白A1c、血清胱抑素C及血脂水平。结果:两组临床疗效比较,差异无统计学意义(P>0.05),治疗组在降低24 h尿蛋白、尿白蛋白排泄率、血清胱抑素C、甘油三脂、低密度脂蛋白胆固醇水平,升高高密度脂蛋白胆固醇水平方面显著优于对照组。结论:益肾化瘀通络法可降低Ⅳ期DN患者尿蛋白,促进肾小球滤过,调节血脂水平,从而延缓肾功能减退。
Objective: To observe the clinical effect of Yishen Huayu Tongluo Therapy on stage Ⅳ diabetic nephropathy (DN). Methods: Sixty-eight patients with DN of deficiency of both qi and yin and blood stasis were randomly divided into treatment group (n = 44) and control group (n = 24). The control group was given routine western medicine antihypertensive treatment based on diet and exercise therapy. Hypoglycemic treatment, the treatment group patients in the control group therapy based on oral Yishen Huayu Tongluo side. After treatment, the clinical curative effect of the two groups was observed. The 24 h urinary protein, urinary albumin excretion rate, fasting blood glucose, glycosylated hemoglobin A1c, serum cystatin C and blood lipid levels were measured before and after treatment. Results: There was no significant difference in clinical curative effect between the two groups (P> 0.05). In the treatment group, the urinary albumin excretion rate, serum cystatin C, triglyceride, low density lipoprotein cholesterol , Higher HDL cholesterol levels were significantly better than the control group. Conclusion: Yishen Huayu Tongluo Decoction can reduce urinary protein in patients with stage Ⅳ DN, promote glomerular filtration and regulate blood lipid levels, thus retarding renal dysfunction.