目的 观察祛浊清源汤治疗糖尿病肾病患者的临床疗效及对其肾功能指标的影响.方法 选取2019年9月-2021年3月期间衡水市中医医院收治的120例糖尿病肾病患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各60例.两组患者均给予优质蛋白、降糖、利尿消肿等基础治疗.对照组给予依那普利治疗,观察组在对照组基础上给予祛浊清源汤口服.连续治疗16周后,观察比较两组患者临床疗效,治疗前及治疗16周后中医证候积分,肾功能指标[血清肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、24 h尿蛋白定量(24 h urine protein quantification,24 h UPQ)、24 h 尿微量白蛋白排泄率(24 h urine microalbumin excre-tion rate,24 h UAER)]水平及不良反应发生情况.结果 治疗后观察组临床总有效率93.33%(56/60)明显高于对照组78.33%(47/60),差异有统计学意义(P<0.05).治疗后两组患者神疲乏力、少气懒言、腰膝酸软、口干咽燥、潮热盗汗、夜尿频多积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组神疲乏力、少气懒言、腰膝酸软、口干咽燥、潮热盗汗、夜尿频多积分均较对照组明显降低,差异有统计学意义(P<0.05).治疗后两组患者肾功能24 h UAER、24 h UPQ、BUN、Scr水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组肾功能24 h UAER、24 h UPQ、BUN、Scr水平均较对照组明显降低,差异有统计学意义(P<0.05).治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05).结论 祛浊清源汤治疗糖尿病肾病疗效较好,能够明显改善中医症状,同时可以改善肾功能,具有较高安全性,具有临床推广意义.
Clinical Efficacy of Quzhuo Qingyuan Decoction in Treating Diabetic Nephropathy and Its Impact on Renal Function Indexes
Objective To observe the clinical efficacy of Quzhuo Qingyuan Decoction in treating diabetic ne-phropathy and its impact on renal function indexes.Methods A total of 120 diabetic nephropathy patients admitted to Hengshui Hospital of Traditional Chinese Medicine from September 2019 to March 2021 were selected.They were divided into an observation group and a control groupby random number table,with 60 in each group.Both groups received basic treatments including high-quality protein,hypoglycemic agents,and diuretic and anti-edema therapy.The control group was treated with enalapril,while the observation group was given Quzhuo Qingyuan Decoction on the basis of the control group.After 16 weeks of continuous treatment,clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN),24-hour urine protein quantification(24 h UPQ),and 24-hour urinary microalbumin excretion rate(24 h UAER)],and incidence of adverse reactions were observed and compared between the two groups.Results The total effective rate of the observation group(93.33%,56/60)was higher than that of the control group(78.33%,47/60)after treatment(P<0.05).Scores for symptoms such as fatigue,shortness of breath and speech,soreness of waist and knees,dry mouth and throat,hot flashes with sweating,and frequent night urina-tion decreased in both groups after treatment(P<0.05),and these symptom scores were lower in the observation group compared with the control group(P<0.05).Renal function indexes including 24 h UAER,24 h UPQ,BUN,and Scr levels dropped in the two groups after treatment(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).No significant difference in the total incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Quzhuo Qingyuan Decoction was effective in treating diabetic nephropa-thy,which markedly improved TCM symptoms and renal function with high safety,suggesting its value for clinical application.
Diabetic nephropathyTurbid vein theoryQuzhuo Qingyuan DecoctionTraditional Chinese medicine(TCM)syndrome scoreRenal function