温肾补气活血方治疗糖尿病肾病Ⅲ期临床观察

罗屏 谭海灯 曾富元

摘要：目的 评价温肾补气活血方治疗糖尿病肾病Ⅲ期的临床疗效与药物安全性。方法 将60例患者随机分为对照组与观察组各30例，所有患者均予基础的治疗方案，将血糖、血压、血脂控制在合理范围，观察组另予口服温肾补气活血方治疗，3个月后进行观察指标评定。结果 与治疗前对比，2组患者的UACR、BUN、Scr均显著改善（P<0.05），且观察组较对照组改善明显（P<0.05）;与治疗前对比，2组患者的eGFR均有所上升（P<0.05），观察组较对照组的eGFR上升程度更为显著（P<0.05）;不良反应发生率方面，观察组为6.67%，对照组对16.67%，2组对比（P<0.05）。结论 严格控制血糖、血压、血脂等基础治疗有利于延缓糖尿病肾病的进程，而温肾补气活血方在改善脾肾阳虚兼血瘀证患者肾功能方面效果显著，有效延缓肾功能衰竭的进程，改善疾病的预后，且药物安全性高，值得临床推广。

关键词：糖尿病肾病Ⅲ期;温肾补气活血方;肾功能;药物安全性

中图分类号：R587.2 文献标志码：B 文章编号：1007-2349（2020）08-0026-04

【Abstract】Objective： To evaluate the clinical effect and drug safety of Wenshen Buqi Huoxue Prescription in the treatment of diabetic nephropathy patients （stage Ⅲ）. Methods： 60 patients were randomly divided into a control group and an observation group， 30 cases per group. All patients were given basic treatment plan to control blood glucose， blood pressure and blood lipid within a reasonable range and the observation group was added oral Wenshen Buqi Huoxue Prescription. The observation index was evaluated 3 months later. Results： In comparison with those of the pre-treatment， the UACR， BUN and Scr of the two groups were significantly improved （P<0.05）. The observation group was significantly better than the control group （P<0.05）. Compared with that of the pre-treatment， the eGFR of the two groups were increased and the eGFR in the observation group was more significant than that in the control group （P<0.05）.The incidence of adverse reactions was 6.67% in the observation group and 16.67% in the control group （P<0.05）. Conclusion： The strict control of blood glucose， blood pressure and blood lipids is beneficial to delay the progression of diabetic nephropathy and Wenshen Buqi Huoxue Prescription is effective in improving the renal function of patients with spleen and kidney yang deficiency and blood stasis syndrome， and effectively delays the progression of renal failure， improve the prognosis of the disease， and the drug has high safety and is worthy of clinical application.

【Key words】diabetic nephropathy （stage Ⅲ）， Wenshen Buqi Huoxue Prescription， renal function， drug safety

糖尿病腎病（Diabetic NePhroPathy，DN），是糖尿病常见的严重慢性微血管并发症[1]，临床多表现为持续的蛋白尿、水肿、肾性高血压等，严重者可导致死亡[2]。近年来由于我国经济迅速发展、居民饮食结构的改变、对疾病的重视程度提高，2型糖尿病的发病率逐年上升[3]，而糖尿病肾病已成为我国引起终末期肾病的首要病因[4]。中医虽无糖尿病肾病的病名，根据其症状、体征，归于“消渴”、“水肿”、“尿浊”、“关格”等范畴，中医的辨证施治、“未病先防，既病防变”的治未病思想、整体观等核心观念在治疗糖尿病肾病体现出了极大的优势，前景可观[5]。本研究选用的温肾补气活血方对脾肾阳虚兼血瘀的糖尿病肾病Ⅲ期患者进行中医药干预，临床疗效满意，药物安全性高，现报道如下。