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目的观察糖肾升清降浊颗粒治疗蛋白尿期糖尿病肾病(DN)的临床疗效。方法将96例蛋白尿期DN患者随机分为治疗组和对照组,每组48例。在相同常规对症治疗的基础上,治疗组加予糖肾升清降浊颗粒口服,对照组加予盐酸贝那普利片治疗。两组疗程均为3个月,观察临床疗效,比较中医证候积分、尿微量白蛋白、24 h尿蛋白定量、空腹血糖(FPG)、糖化血红蛋白(HbA1c),及血肌酐(SCr)、尿素氮(BUN)、总胆固醇(TC)、三酰甘油(TG)的变化情况。结果①治疗组、对照组临床总有效率分别为85.42%和66.67%;组间临床疗效比较,治疗组显著优于对照组(P<0.05)。②组间治疗前后差值比较,治疗组中医证候积分降低程度比对照组更加明显(P<0.05)。③组间治疗后比较,治疗组尿微量白蛋白、24 h尿蛋白定量下降程度比对照组更加显著(P<0.05)。④组间治疗后比较,SCr、BUN水平差异无统计学意义(P>0.05),而FPG、HbA1c、TC、TG水平治疗组均显著低于对照组(P<0.05)。结论糖肾升清降浊颗粒治疗蛋白尿期DN,在控制血糖的同时兼有保护肾功能、降低尿蛋白、改善脂代谢等作用。
Objective To observe the clinical effect of Tangshen Shengqing Jiangzhuo granule in the treatment of proteinuria diabetic nephropathy (DN). Methods 96 cases of proteinuria DN patients were randomly divided into treatment group and control group, 48 cases in each group. On the basis of the same conventional symptomatic treatment, the treatment group was treated with oral glucose and shengqing Jiangzhuo granule and the control group with benazepril hydrochloride tablets. The two groups were treated for 3 months, and the clinical curative effect was observed. The TCM syndrome score, urinary microalbuminuria, 24 h urinary protein, fasting blood glucose (FPG), HbA1c and serum creatinine (SCr) Nitrogen (BUN), total cholesterol (TC), triglyceride (TG) changes. Results ① The total clinical effective rates of the treatment group and the control group were 85.42% and 66.67% respectively. The clinical efficacy of the treatment group was significantly better than that of the control group (P <0.05). ②Comparison between groups before and after treatment, the TCM syndrome scores in the treatment group decreased more significantly than those in the control group (P <0.05). ③ After treatment, urinary microalbuminuria, 24 h urinary protein in the treatment group decreased more quantitatively than the control group (P <0.05). ④ After treatment, the levels of SCr and BUN were not significantly different between the two groups (P> 0.05), while the levels of FPG, HbA1c, TC and TG in the treatment group were significantly lower than those in the control group (P <0.05). Conclusions Tangshen Shengqing Jiangzhuo granule can treat DN of proteinuria, meanwhile it can protect renal function, reduce urinary protein and improve lipid metabolism while controlling blood sugar.