厄贝沙坦片联合丹芪益肾方对气阴两虚兼血瘀型糖尿病肾病的临床防治研究
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摘要
【目的】分析厄贝沙坦片联合丹芪益肾方在早期糖尿病肾病气阴两虚兼血瘀证患者中的防治效果。【方法】将132例早期糖尿病肾病气阴两虚兼血瘀证患者随机分为观察组和对照组,每组各66例。观察组给予厄贝沙坦片联合丹芪益肾方治疗,对照组给予厄贝沙坦片治疗,观察2组患者治疗前后血糖指标及肾功能指标的变化情况,并评估2组的临床疗效。【结果】(1)治疗后,2组患者的血糖指标(空腹血糖、餐后2 h血糖)和肾功能指标(血肌酐、24 h尿蛋白、尿素氮)均较治疗前改善(P<0.05),且观察组对空腹血糖、餐后2 h血糖及血肌酐、24 h尿蛋白等指标的改善作用优于对照组,差异均有统计学意义(P<0.05)。(2)经治疗3个月后,观察组的控制率及总有效率分别为43.94%和89.39%,对照组分别为27.27%和75.76%,观察组的控制率及总有效率均高于对照组,差异有统计学意义(P<0.05)。【结论】厄贝沙坦片联合丹芪益肾方治疗早期糖尿病肾病气阴两虚兼血瘀证患者,具有较好疗效,能改善患者的血糖指标,保护患者的肾功能。
Objective To investigate the preventive and therapeutic effect of Irbesartan Tablets plus Danqi Yishen Decoction(DYD)on early diabetic nephropathy(DN)with the syndrome of Qi-yin deficiency complicated byblood stasis. Methods One hundred and thirty-two early DN patients with the syndrome of Qi-yin deficiencycomplicated by blood stasis were randomly divided into observation group and control group, 66 cases in eachgroup. The observation group was given oral use of Irbesartan Tablets and Danqi Yishen Decoction,and the controlgroup was given oral use of Irbesartan Tablets alone. The blood glucose level and renal function parameters in thetwo groups before and after treatment were observed,and the clinical efficacy of the two groups was evaluated aftertreatment. Results(1)After treatment,the levels of blood glucose indices(fasting plasma glucose,postprandial2-hour blood glucose)and renal function parameters(serum creatinine,24-hour urine protein,urea nitrogen)ofboth groups after treatment were improved as compared with those before treatment(P < 0.05),the improvement ofthe fasting plasma glucose,postprandial 2-hour blood glucose,serum creatinine,24-hour urine protein in theobservation group was superior to that in the control group(P < 0.05).(2)After treatment for 3 months, thedisease-control rate and total effective rate in the observation group were 43.94% and 89.39%,and those in thecontrol group were 27.27% and 75.76%,respectively. The observation group had higher disease-control rate andtotal effective rate than the control group, the differences being significant(P < 0.05). Conclusion IrbesartanTablets plus Danqi Yishen Decoction has better curative effects on early DN with the syndrome of Qi-yin deficiencycomplicated by blood stasis,and can improve blood glucose and protect renal function.
Objective To investigate the preventive and therapeutic effect of Irbesartan Tablets plus Danqi Yishen Decoction(DYD)on early diabetic nephropathy(DN)with the syndrome of Qi-yin deficiency complicated byblood stasis. Methods One hundred and thirty-two early DN patients with the syndrome of Qi-yin deficiencycomplicated by blood stasis were randomly divided into observation group and control group, 66 cases in eachgroup. The observation group was given oral use of Irbesartan Tablets and Danqi Yishen Decoction,and the controlgroup was given oral use of Irbesartan Tablets alone. The blood glucose level and renal function parameters in thetwo groups before and after treatment were observed,and the clinical efficacy of the two groups was evaluated aftertreatment. Results(1)After treatment,the levels of blood glucose indices(fasting plasma glucose,postprandial2-hour blood glucose)and renal function parameters(serum creatinine,24-hour urine protein,urea nitrogen)ofboth groups after treatment were improved as compared with those before treatment(P < 0.05),the improvement ofthe fasting plasma glucose,postprandial 2-hour blood glucose,serum creatinine,24-hour urine protein in theobservation group was superior to that in the control group(P < 0.05).(2)After treatment for 3 months, thedisease-control rate and total effective rate in the observation group were 43.94% and 89.39%,and those in thecontrol group were 27.27% and 75.76%,respectively. The observation group had higher disease-control rate andtotal effective rate than the control group, the differences being significant(P < 0.05). Conclusion IrbesartanTablets plus Danqi Yishen Decoction has better curative effects on early DN with the syndrome of Qi-yin deficiencycomplicated by blood stasis,and can improve blood glucose and protect renal function.
引文
[1]贺学允,陈玉玲.益气养阴活血汤联合阿托伐他汀治疗气阴两虚兼血瘀型早期糖尿病肾病效果分析[J].临床与病理杂志,2016,36(6):810.
[2]张术佳.肾炎康复片治疗86例糖尿病肾病的临床疗效观察[J].中国医药指南,2015,18(3):217.
[3]丁静明.缬沙坦胶囊、厄贝沙坦片治疗糖尿病肾病患者的临床观察[J].中外医学研究,2016,14(31):147.
[4]王丹.中西医结合治疗早期糖尿病肾病的疗效观察[J].中西医结合心血管病电子杂志,2015,3(23):75.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[S].2018.
[6]刘海波.血管内皮生长因子在糖尿病眼部并发症发生、发展中的作用及其与血清胰岛素样生长因子之间的关系分析[J].中华临床医师杂志(电子版),2015,9(16):3130.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:233-237.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[9]王澎澎,张艳.针灸联合益气活血方对早期糖尿病心肌病气阴两虚兼血瘀型病人心功能、心肌酶谱及血流动力学的影响[J].中西医结合心脑血管病杂志,2017,15(2):142.
[10]欧阳慧玉,秦利强,石梅,等.厄贝沙坦联合使用苯磺酸氨氯地平对102例男性糖尿病肾病合并高血压患者的疗效分析[J].中国医药导刊,2016,18(2):161.
[11]王兴华,童奎骅.三黄肾病方治疗早期糖尿病肾病的临床研究[J].中国中西医结合肾病杂志,2015,22(7):612.
[12]耿国民,李松林,高大汉,等.肾维康汤联合厄贝沙坦治疗糖尿病肾病30例[J].中国药业,2015,24(6):87.
[13]Shen W.Clinical observation of Irbesartan Tablets combined with alpha keto-acid in the treatment of early diabetic nephropathy[J].Journal of North Pharmacy,2017,14(3):33.
[14]张雪丹.渴络欣胶囊配合厄贝沙坦片治疗早期糖尿病肾病临床研究[J].国际中医中药杂志,2016,38(10):884.
[15]赵玉秀.厄贝沙坦片联合参芪六味地黄丸加减治疗早期糖尿病肾病的临床研究[J].糖尿病新世界,2016,19(5):16.
[16]张红彤.厄贝沙坦联合丹参川芎嗪治疗糖尿病肾病临床分析[J].中外医学研究,2015,10(24):114.
[17]田领,刘景峰,勾艳丽,等.通心络胶囊联合厄贝沙坦对早期糖尿病肾病患者肾功能及内皮功能的影响[J].疑难病杂志,2015,11(6):615.
[18]郑锦桥,饶惠平,黄瑞文,等.厄贝沙坦对早期糖尿病肾病患者颈动脉内膜中层厚度及临床生化指标的影响[J].中国医学创新,2015,26(19):57.
[19]张坤,任巧华,吴韬,等.西格列汀单用或联合厄贝沙坦对早期糖尿病肾病白细胞介素18等指标的影响[J].空军医学杂志,2016,32(1):56.
[20]薛洪敏.中医益气补肾化瘀法治疗早期糖尿病肾病疗效观察[J].亚太传统医药,2015,11(17):102.
[21]姜果.益气养阴消癥通络法治疗早期糖尿病肾病的可行性分析[J].中国当代医药,2017,24(2):147.
[22]彭亚军,何泽云,彭亚平,等.加减猪苓汤治疗糖尿病肾病Ⅳ期的临床观察及对尿AQP2的影响[J].世界中西医结合杂志,2016,11(10):1376.
[23]Chen Q.The effect of irbesartan combined with calcium antagonist in the treatment of elderly patients with type 2 diabetic nephropathy complicated with hypertension[J].J Clin Exp Med,2015,34(10):832.
[24]胡国庆,陈筑红.益气养阴活血汤治疗气阴两虚型早期糖尿病肾病临床疗效研究[J].中国药业,2016,25(15):43.
[2]张术佳.肾炎康复片治疗86例糖尿病肾病的临床疗效观察[J].中国医药指南,2015,18(3):217.
[3]丁静明.缬沙坦胶囊、厄贝沙坦片治疗糖尿病肾病患者的临床观察[J].中外医学研究,2016,14(31):147.
[4]王丹.中西医结合治疗早期糖尿病肾病的疗效观察[J].中西医结合心血管病电子杂志,2015,3(23):75.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[S].2018.
[6]刘海波.血管内皮生长因子在糖尿病眼部并发症发生、发展中的作用及其与血清胰岛素样生长因子之间的关系分析[J].中华临床医师杂志(电子版),2015,9(16):3130.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:233-237.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[9]王澎澎,张艳.针灸联合益气活血方对早期糖尿病心肌病气阴两虚兼血瘀型病人心功能、心肌酶谱及血流动力学的影响[J].中西医结合心脑血管病杂志,2017,15(2):142.
[10]欧阳慧玉,秦利强,石梅,等.厄贝沙坦联合使用苯磺酸氨氯地平对102例男性糖尿病肾病合并高血压患者的疗效分析[J].中国医药导刊,2016,18(2):161.
[11]王兴华,童奎骅.三黄肾病方治疗早期糖尿病肾病的临床研究[J].中国中西医结合肾病杂志,2015,22(7):612.
[12]耿国民,李松林,高大汉,等.肾维康汤联合厄贝沙坦治疗糖尿病肾病30例[J].中国药业,2015,24(6):87.
[13]Shen W.Clinical observation of Irbesartan Tablets combined with alpha keto-acid in the treatment of early diabetic nephropathy[J].Journal of North Pharmacy,2017,14(3):33.
[14]张雪丹.渴络欣胶囊配合厄贝沙坦片治疗早期糖尿病肾病临床研究[J].国际中医中药杂志,2016,38(10):884.
[15]赵玉秀.厄贝沙坦片联合参芪六味地黄丸加减治疗早期糖尿病肾病的临床研究[J].糖尿病新世界,2016,19(5):16.
[16]张红彤.厄贝沙坦联合丹参川芎嗪治疗糖尿病肾病临床分析[J].中外医学研究,2015,10(24):114.
[17]田领,刘景峰,勾艳丽,等.通心络胶囊联合厄贝沙坦对早期糖尿病肾病患者肾功能及内皮功能的影响[J].疑难病杂志,2015,11(6):615.
[18]郑锦桥,饶惠平,黄瑞文,等.厄贝沙坦对早期糖尿病肾病患者颈动脉内膜中层厚度及临床生化指标的影响[J].中国医学创新,2015,26(19):57.
[19]张坤,任巧华,吴韬,等.西格列汀单用或联合厄贝沙坦对早期糖尿病肾病白细胞介素18等指标的影响[J].空军医学杂志,2016,32(1):56.
[20]薛洪敏.中医益气补肾化瘀法治疗早期糖尿病肾病疗效观察[J].亚太传统医药,2015,11(17):102.
[21]姜果.益气养阴消癥通络法治疗早期糖尿病肾病的可行性分析[J].中国当代医药,2017,24(2):147.
[22]彭亚军,何泽云,彭亚平,等.加减猪苓汤治疗糖尿病肾病Ⅳ期的临床观察及对尿AQP2的影响[J].世界中西医结合杂志,2016,11(10):1376.
[23]Chen Q.The effect of irbesartan combined with calcium antagonist in the treatment of elderly patients with type 2 diabetic nephropathy complicated with hypertension[J].J Clin Exp Med,2015,34(10):832.
[24]胡国庆,陈筑红.益气养阴活血汤治疗气阴两虚型早期糖尿病肾病临床疗效研究[J].中国药业,2016,25(15):43.