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目的:观察健脾补肾化瘀汤联合常规西药治疗脾肾两虚夹瘀型糖尿病肾病(DN)的临床疗效。方法:选取168例脾肾两虚夹瘀型DN患者作为研究对象,随机分为对照组80例与观察组88例。对照组给予常规西药治疗,观察组在对照组用药基础上联合健脾补肾化瘀汤治疗。比较2组临床疗效,以及治疗前后空腹血糖(FBG)、尿糖(GLU)、尿白蛋白排泄率(UAE)、血肌酐(SCr)、尿素氮(BUN)水平和血液流变学指标(红细胞压积、血浆黏度、纤维蛋白原)的变化。结果:观察组与对照组的总有效率分别为89.77%和71.25%。2组比较,差有统计学意义(P<0.05)。治疗前,2组FBG、GLU、UAE、SCr、BUN水平和红细胞压积、血浆黏度、纤维蛋白原比较,差异均无统计学意义(P>0.05)。治疗后,2组FBG、GLU、UAE、SCr、BUN水平均较治疗前改善(P<0.05),观察组以上5项指标的改善情况均优于对照组(P<0.05);2组3项血液流变学指标均较治疗前改善(P<0.05),观察组3项血液流变学指标的改善情况均优于对照组(P<0.05)。结论:健脾补肾化瘀汤联合常规西药治疗脾肾两虚夹瘀型DN,临床疗效优于单纯常规西药治疗,能进一步改善患者的肾功能及血液流变学指标。
Objective: To observe the clinical efficacy of Jianpi Bushen Huayu Decoction combined with conventional western medicine in treating diabetic nephropathy (DN) of spleen and kidney both stagnation of blood stasis type. Methods: A total of 168 cases of DN patients with spleen and kidney syndrome of deficiency of blood stasis type were randomly divided into control group (n = 80) and observation group (n = 88). The control group was given conventional Western medicine, and the observation group was treated with the combination of Jianpi Bushen Huayu Tang on the basis of the control group. The clinical efficacy, FBG, urinary albumin excretion (UAE), serum creatinine (SCr), blood urea nitrogen (BUN) and blood rheology Pressure, plasma viscosity, fibrinogen) changes. Results: The total effective rate of observation group and control group were 89.77% and 71.25% respectively. The difference between the two groups was statistically significant (P <0.05). Before treatment, the levels of FBG, GLU, UAE, SCr, BUN, hematocrit, plasma viscosity and fibrinogen in two groups had no significant difference (P> 0.05). After treatment, the levels of FBG, GLU, UAE, SCr and BUN in both groups were improved compared with that before treatment (P <0.05). The improvement of the above five indexes in the observation group was better than that in the control group (P <0.05) The indexes of hemorheology were improved than those before treatment (P <0.05). The improvement of three hemorrheological indexes in the observation group was better than that in the control group (P <0.05). Conclusion: Jianpi Bushen Huayu Decoction combined with conventional western medicine can effectively improve the renal function and hemorheology of DN patients.