养阴活血泄浊方治疗早期糖尿病肾病的效果与安全性观察

丁云东

[摘要] 目的 观察采用养阴活血泄浊方治疗早期糖尿病肾病的临床疗效。 方法 回顾性分析76例早期糖尿病肾病患者资料，根据治疗方法分为治疗组（45例）和对照组（31例），均给予控制饮食、血糖、适量运动等糖尿病基础治疗，对照组采用西医常规治疗，并根据病情使用降糖药，在此基础上，治疗组加用养阴活血泄浊中药方剂，治疗周期为12周。观察两组治疗前后的实验室检查指标及不良反应。 结果 治疗12周后，两组治疗后的各主要指标（FCG、HbAlC、TG、LDL-C、mAlb、UAER、hs-CRP、Cys C）均较治疗前有明显改善，差异有统计学意义（P<0.05）；且治疗组治疗后的各值较对照组治疗后改善更明显，差异有统计学意义（P<0.05）。 结论 养阴活血泄浊方治疗早期糖尿病肾病能有效改善各主要实验指标值，具有较好的临床疗效，值得临床运用推广。

[关键词] 早期糖尿病肾病；养阴活血泄浊方；中药；安全性

[中图分类号] R277.5 [文献标识码] A [文章编号] 2095-0616（2015）17-19-04

Observation of clinical efficacy and safety of treatment with Yangyinhuoxuexiezhuo Fang on early diabetic nephropathy

DING Yundong

Guyuetao Studio，the TCM Hospital of Liaocheng City，Liaocheng 252000，China

[Abstract] Objective To observe the clinical efficacy and safety of treatment with Yangyin Huoxue Xiezhuo Fang on early diabetic nephropathy. Methods 76 patients with early diabetic nephropathy were divided into treatment group（45 cases）and control group（31 cases）follow the treatment methods retrospectively，and basic treatments for diabetes like controlling diet and blood glucose，exercising moderately were conducted on all patients；the control group used the conventional western medicine treatment，and hypoglycemic agents was used according to the disease，on that basis，the treatment group was given Yangyin Huoxue Xiezhuo Fang，and the treatment lasted for 12 weeks.The laboratory parameters before and after treatment，and adverse events were compared. Results After 12 weeks of treatment，the experimental index value（FCG、HbAlC、TG、LDL-C、mAlb、UAER、hs-CRP、Cys C）in both control group and treatment group were obviously improved comparing with that before treatment（P<0.05）.The value in treatment group presented a better improvement than that in the control group after treatment（P<0.05）. Conclusion Yangyin Huoxue Xiezhuo Fang on early diabetic nephropathy can effectively control the experimental index value， and has a good clinical efficacy that it is worth widely used in the clinic.

[Key words] Early diabetic nephropathy；Yangyin Huoxue Xiezhuo Fang；Traditional Chinese medicine；Safety

糖尿病肾病（diabetic nephropathy，DN）是糖尿病最常见、最严重的慢性并发症之一，是代谢异常导致的肾小球硬化症[1]，也是目前导致肾功能衰竭的重要原因之一，甚至有国外研究认为DN已成为终末期肾病的首要原因。而在我国DN也已成为导致慢性肾功能衰竭的第3大原因[2]。研究发现控制尿微量蛋白有助于延缓DN的病程，因此，减少尿微量蛋白的排泄对早期DN的治疗在临床上显得尤为重要。目前西医对本病缺乏特效药物，本研究在西医常规治疗基础上加用养阴活血泄浊方治疗早期DN，疗效满意，现报道如下。

1 资料与方法

1.1 一般资料

所有患者均来自我院2014年1月～2015年1月住院及门诊病例，符合1999年WHO对DM的诊断标准及分型[3]。按mogensenDN分期标准[4]，诊断为DN Ⅲ期，即微量蛋白尿期，尿蛋白排出率（UAER）20～200μg/min（或>30mg/24h），至少检查2次，持续3个月；血脂异常，血清甘油三酯（TG）≥2.2mmol/L，血清总胆固醇（TC）≥4.5mmol/L；血压正常或者轻度高血压（血压均为≤140/90mm Hg）；血肌酐（Scr）<112.3μmol/L。排除严重的肝、心及造