黄芪知母参七颗粒治疗气阴两虚型糖尿病肾脏疾病的临床疗效观察
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摘要
目的：通过观察24h尿蛋白定量(UP-24)、血清C反应蛋白(CRP)、纤维蛋白原(Fib)水平的变化,以及糖尿病视网膜病变(DR)的变化,评价知母参七颗粒治疗气阴两虚型糖尿病肾脏疾病(DKD)Ⅲ、Ⅳ期的临床疗效及探讨其对DKD可能的作用机制；以期对DKD的早期防治,延缓DKD患者肾功能损害进展,减少患者进入DKD 5期和行替代治疗。方法：选择就诊于南京军区福州总医院肾内科、内分泌科、中医科门诊的气阴两虚型DKDⅢ、Ⅳ期患者60例,随机分为治疗组30例与对照组30例,对照组予西医常规治疗,治疗组在对照组相同治疗的基础上加用黄芪知母参七颗粒,疗程为8周,观察两组对中医临床症状、对UP-24、CRP、Fib水平及对DR的影响。
结果：(1)两组治疗后中医临床症状改善,其中治疗组对中医临床症状改善的有效率为96.7%,对照组为73.3%,治疗组疗效优于对照组(p<0.05)。(2)治疗后24h尿蛋白定量较治疗前明显改善(p<0.05),治疗组有效率为86.7%,对照组为76.7%,两组疗效无显著差别(p>0.05)。(3) CRP水平、Fib水平较治疗前均下降(p<0.05)。治疗前后两组在CRP的差值、PU-24的差值、Fib的差值三者之间均有明显相关性(p<0.05)。(4) DKD一般伴随DR的发生,治疗后DR情况明显改善(p<0.05),治疗组有效率为87%,对照组有效率为82.6%。两组疗效无显著差别(p>0.05)。(5)治疗期间无心、肝、肾功能异常,无电解质紊乱。
结论：(1)两组治疗后患者临床症状评分、UP-24、CRP、Fib及DR情况均较治疗前好转。(2)两组的UP-24、CRP、Fib在治疗前后的差值有明显相关性。(3)导师经验方“黄芪知母参七颗粒”治疗气阴两虚型DKDⅢ、Ⅳ期,能明显缓解其症状、体征,其疗效确切、使用安全、无明显副作用,值得推广应用。
Objective:By observing the changes of 24h urine protein (UP-24), serum C-reactive protein (CRP), fibrinogen (Fib) levels, as well as diabetic retinopathy (DR) the change " Huangqizhimushenqi Granula " diabetic kidney disease (DKD) the 3rd or 4rd stage with qi and yin vacuity, the clinical efficacy and to explore its possible mechanism of DKD; with a view to DKD early prevention and treatment of renal dysfunction in patients with DKD slow progress in reducing the duration and in patients with DKD 5th stage into the replacement treatment.
Methods:Select treatment in Nanjing Military Region, Fuzhou General Hospital, Department of Nephrology, Department of Endocrinology, and Chinese medicine outpatient clinic of the Qi and Yin vacuity the 3rd or 4th stage DKD 60 patients were randomly divided into control groups with 30 patients and treatment group of 30 patients treated with Huangqizhimushenqi Granula in the control group to the conventional Western medicine treatment to 8 weeks as a course of treatment, were observed therapy Qi and Yin vacuity the 3rd or 4th stage DKD, the clinical efficacy and UP-24, CRP、Fib levels and DR.
Results:(1) groups before and after treatment the clinical symptoms of traditional Chinese medicine. treatment group was more effective than the control group (p<0.05). The treatment group response rate was 96.7% while the control group response rate was 73.3%. (2) 24h urine protein after treatment compared with pre-treatment significantly improved (p<0.05), treatment group 86.7% in the control group was 76.7%, no significant difference in efficacy of the two groups (p>0.05). (3) Crp and fib level than before treating are falling (p<0.05).In the CRP before and after treatment the difference between the two groups, UP-24 margin, Fib were significantly difference among the correlation (p<0.05).(4) DKD generally associated with the occurrence of DR, DR situation improved significantly after treatment (p<0.05), the treatment group was 87% in the control group response rate was 82.6%. The therapeutic effect was no significant difference (p>0.05). (5) inadvertently during treatment, liver and kidney dysfunction, no electrolyte imbalance.
Conclusions:(1) After treatment, clinical symptom score, UP-24, CRP, Fib, and DR conditions better than those before treatment. (2) groups of UP-24, CRP, Fib difference before and after treatment there is significant correlation. (3) instructor experience side, " Huangqizhimushenqi Granula " treatment Qi and Yin vacuity DKD 3rd or 4th stage, can significantly alleviate the symptoms, signs, can significantly improve its curative effect, the use of safe, non-obvious side effects, it is worth popularization and application.
结果：(1)两组治疗后中医临床症状改善,其中治疗组对中医临床症状改善的有效率为96.7%,对照组为73.3%,治疗组疗效优于对照组(p<0.05)。(2)治疗后24h尿蛋白定量较治疗前明显改善(p<0.05),治疗组有效率为86.7%,对照组为76.7%,两组疗效无显著差别(p>0.05)。(3) CRP水平、Fib水平较治疗前均下降(p<0.05)。治疗前后两组在CRP的差值、PU-24的差值、Fib的差值三者之间均有明显相关性(p<0.05)。(4) DKD一般伴随DR的发生,治疗后DR情况明显改善(p<0.05),治疗组有效率为87%,对照组有效率为82.6%。两组疗效无显著差别(p>0.05)。(5)治疗期间无心、肝、肾功能异常,无电解质紊乱。
结论：(1)两组治疗后患者临床症状评分、UP-24、CRP、Fib及DR情况均较治疗前好转。(2)两组的UP-24、CRP、Fib在治疗前后的差值有明显相关性。(3)导师经验方“黄芪知母参七颗粒”治疗气阴两虚型DKDⅢ、Ⅳ期,能明显缓解其症状、体征,其疗效确切、使用安全、无明显副作用,值得推广应用。
Objective:By observing the changes of 24h urine protein (UP-24), serum C-reactive protein (CRP), fibrinogen (Fib) levels, as well as diabetic retinopathy (DR) the change " Huangqizhimushenqi Granula " diabetic kidney disease (DKD) the 3rd or 4rd stage with qi and yin vacuity, the clinical efficacy and to explore its possible mechanism of DKD; with a view to DKD early prevention and treatment of renal dysfunction in patients with DKD slow progress in reducing the duration and in patients with DKD 5th stage into the replacement treatment.
Methods:Select treatment in Nanjing Military Region, Fuzhou General Hospital, Department of Nephrology, Department of Endocrinology, and Chinese medicine outpatient clinic of the Qi and Yin vacuity the 3rd or 4th stage DKD 60 patients were randomly divided into control groups with 30 patients and treatment group of 30 patients treated with Huangqizhimushenqi Granula in the control group to the conventional Western medicine treatment to 8 weeks as a course of treatment, were observed therapy Qi and Yin vacuity the 3rd or 4th stage DKD, the clinical efficacy and UP-24, CRP、Fib levels and DR.
Results:(1) groups before and after treatment the clinical symptoms of traditional Chinese medicine. treatment group was more effective than the control group (p<0.05). The treatment group response rate was 96.7% while the control group response rate was 73.3%. (2) 24h urine protein after treatment compared with pre-treatment significantly improved (p<0.05), treatment group 86.7% in the control group was 76.7%, no significant difference in efficacy of the two groups (p>0.05). (3) Crp and fib level than before treating are falling (p<0.05).In the CRP before and after treatment the difference between the two groups, UP-24 margin, Fib were significantly difference among the correlation (p<0.05).(4) DKD generally associated with the occurrence of DR, DR situation improved significantly after treatment (p<0.05), the treatment group was 87% in the control group response rate was 82.6%. The therapeutic effect was no significant difference (p>0.05). (5) inadvertently during treatment, liver and kidney dysfunction, no electrolyte imbalance.
Conclusions:(1) After treatment, clinical symptom score, UP-24, CRP, Fib, and DR conditions better than those before treatment. (2) groups of UP-24, CRP, Fib difference before and after treatment there is significant correlation. (3) instructor experience side, " Huangqizhimushenqi Granula " treatment Qi and Yin vacuity DKD 3rd or 4th stage, can significantly alleviate the symptoms, signs, can significantly improve its curative effect, the use of safe, non-obvious side effects, it is worth popularization and application.
引文
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