【摘要】 目的:观察补肾活血方联合缬沙坦胶囊治疗2型糖尿病肾病（diabetic nephropathy,DN）Ⅲ期的临床疗效。方法:将62例患者随机分为对照组32例、观察组30例,2组均服用缬沙坦胶囊,观察组加服补肾活血方,2组均连续治疗2个月。观察2组治疗前后中医证候积分,餐前血糖（FBG）、餐后2小时血糖（2h PBG）、糖化血红蛋白(HbA_1c)、尿微量白蛋白排泄率、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）、尿白蛋白排泄率（UAER）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等指标的变化情况。结果:总有效率观察组为86.67%,对照组为59.37%,2组比较差异有统计学意义（P<0.05）;中医证候总积分治疗前后2组组内比较,差异有统计学意义（P<0.05）;治疗后组间比较,差异也有统计学意义（P<0.05）。FBG、2h PBG及Hb A1c治疗前后2组组内比较,差异有统计学意义（P<0.05）;治疗后组间比较,差异无统计学意义（P>0.05）。观察组IL-6、TNF-α及UAER治疗前后比较,差异有统计学意义（P<0.05）;对照组UAER治疗前后比较,差异有统计学意义（P<0.05）,IL-6、TNF-α治疗前后比较,差异无统计学意义（P>0.05）。IL-6、TNF-α及UAER治疗后2组组间比较,差异有统计学意义（P<0.05）。TC、TG、HDL-C、LDL-C治疗前后2组组内比较,差异有统计学意义（P<0.05）;治疗后组间比较,差异有统计学意义（P<0.05）。AST、ALT、BUN及SCr治疗前后组内及治疗后组间比较,差异均无统计学意义（P>0.05）。结论:补肾活血方联合缬沙坦胶囊治疗Ⅲ期DN可明显改善临床症状,以减少尿蛋白的排泄,减轻炎症反应,延缓DN的进展,且安全、有效。更多还原

【Abstract】 Objective: To observe clinical effects of kidney-tonifying blood-activating prescription combined with valsartan capsules in treating diabetic nephropathy（DN） at stage Ⅲ. Methods: Sixty-two patients were randomized into 32 cases of the control group and 30 cases of the observation group, both groups took valsartan capsules, the observation group took kidney-tonifying blood-activating prescription, both groups were treated for two months consecutively. TCM syndrome scales of both groups were observed before and after treating, FBG, 2 h PBG,HbA_1c, urinary microalbumin excretion rate（UMER）, IL-6, TNF-α, urinary albumin excretion rate（UAER）, TC, TG,HDL-C, LDL-C and others were detected. Results: Total effective rate of the observation group was 86.67%, higher than 59.37% of the control group, and the difference had statistical meaning（P <0.05）; the difference presented statistical meaning in the comparisons of TCM syndrome scales before and after treating within one group（P<0.05）;the difference presented statistical meaning in the comparisons of TCM syndrome scales after treating between two groups（P<0.05）. The difference had statistical meaning in the comparison of FBG, 2 h PBG and Hb A1 cbefore and after treating within one group（P<0.05）; the difference had no statistical meaning in the comparisons between both groups after treating（P >0.05）. The difference had statistical meaning in the comparisons of IL-6, TNF-α and UAER before and after treating within the observation group（P <0.05）; and the difference presented statistical meaning in the comparisons of UAER before and after treating within the control group（P<0.05）; the difference had no statistical meaning in the comparison of IL-6 and TNF-α before and after treating（P>0.05）. The difference had statistical meaning in the comparisons of IL-6, TNF-α and UAER between both groups after treating（P<0.05）. The difference had statistical meaning in the comparisons of TC, TG, HDL-C and LDL-C before and after treating within one group（P<0.05）; the difference had statistical meaning in the comparisons between both groups after treating（P <0.05）. The difference had no statistical meaning in the comparisons of AST, ALT, BUN and SCr before and after treating within one group and between both groups after treating（P >0.05）. Conclusion: Kidney-tonifyingblood-activating prescription combined with valsartan capsules in treating DN at stage Ⅲ could not only improve clinical symptoms obviously, but also reduce urine protein excretion, alleviate inflammatory reaction, delay DN progression, and the therapy is safe and effective.更多还原