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目的:观察温阳益气活血方对初发2型糖尿病患者早期糖尿病肾病(DN)的预防作用。方法:将244例患者用随机数字法分为两组各122例,对照组采取基础治疗,控制血糖、血压和血脂。治疗组在对照组的基础上加用温阳益气活血方。治疗前后检测红细胞压积(HCT)、全血比黏度(RBV)、血浆比黏度(RPV)、纤维蛋白原(FIB)及C反应蛋白(CRP)。随访3个月,观察早期糖尿病肾病新发率。结果:治疗过程中治疗组脱落15例,对照组脱落12例,实际有效病例217例。治疗3个月后,两组HCT、RBV、RPV、FIB及CRP较治疗前改善,差异均有显著性意义(P<0.05);治疗组HCT、RBV、RPV、FIB及CRP较对照组下降,差异均有显著性意义(P<0.05)。6个月内,治疗组早期DN的新发病率为6.36%,明显低于对照组(14.95%),差异有显著性意义(P<0.05)。结论:温阳益气活血方对初发2型糖尿病患者早期糖尿病肾病(DN)有一定的预防作用。其机制可能与降低血液黏度,改善血液流变学和血管微循环,同时具有一定的抗炎作用有关。
Objective: To observe the preventive effect of Warming Yang and Invigorating Qi and Promoting Blood Circulation Prescription on early diabetic nephropathy (DN) in newly diagnosed type 2 diabetic patients. Methods: 244 patients were divided into two groups by random number method 122 cases, the control group to take basic treatment, control blood sugar, blood pressure and blood lipids. On the basis of the control group, the treatment group was treated with Warming Yang and Invigorating Qi and Promoting Blood Circulation. Before and after treatment, hematocrit (HCT), whole blood viscosity (RBV), plasma specific viscosity (RPV), fibrinogen (FIB) and C-reactive protein (CRP) were measured. Followed up for 3 months, observed the incidence of early diabetic nephropathy. Results: In the treatment group, 15 cases of treatment group shedding, 12 cases of control group shedding, the actual effective cases 217 cases. The levels of HCT, RBV, RPV, FIB and CRP in the two groups were significantly improved after treatment for 3 months (P <0.05). The HCT, RBV, RPV, FIB and CRP in the treatment group were significantly lower than those in the control group The difference was significant (P <0.05). Within 6 months, the new incidence of DN in early treatment group was 6.36%, which was significantly lower than that of control group (14.95%), the difference was significant (P <0.05). Conclusion: Wenyang Yiqi Huoxue Decoction can prevent early diabetic nephropathy (DN) in newly diagnosed type 2 diabetic patients. The mechanism may be related to lowering blood viscosity, improving blood rheology and vascular microcirculation, and having certain anti-inflammatory effects.