作者：李红霞1，魏田静1，刘晓宇1，庞丽1，王亚立1，于向慧2

单位：

1.073000河北省定州市，河北中医学院第二附属医院内分泌病科　2.050013河北省石家庄市，河北省中医院内分泌科

Units：

1.Department of Endocrinology, the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine, Dingzhou073000, China2.Department of Endocrinology, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050013, China

关键词：

糖尿病肾病；温脾补肾泄浊汤；厄贝沙坦；治疗结果；氧化应激；炎性因子

Keywords：

Diabetic nephropathies; Wenpi Bushen Xiezhuo decoction; Irbesartan; Treatment outcome; Oxidative stress; Inflammatory factors

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.205

Funds：

河北省中医药管理局科研计划项目（2022402）

摘要：

目的　探讨温脾补肾泄浊汤联合厄贝沙坦治疗糖尿病肾病的疗效。方法　选取2021年6月至2022年1月河北中医学院第二附属医院内分泌病科收治的糖尿病肾病患者100例为研究对象，采用随机数字表法将患者分为对照组和研究组，每组50例。两组患者均给予运动与饮食指导、西医常规治疗，在此基础上，对照组给予厄贝沙坦片口服，研究组在对照组基础上给予温脾补肾泄浊汤治疗，共治疗2个月。比较两组治疗后临床疗效，两组治疗前后中医证候积分、血糖〔空腹血糖、餐后2 h血糖、糖化血红蛋白（HbA1c）〕、肾功能指标〔血尿素氮（BUN）、24 h尿蛋白定量〕、氧化应激指标〔超氧化物歧化酶（SOD）、丙二醛（MDA）〕、炎性因子〔IL-6、IL-8、肿瘤坏死因子α（TNF-α）、超敏C反应蛋白（hs-CRP）〕，记录两组患者治疗期间不良反应发生情况。结果　治疗后研究组临床疗效优于对照组（u =2.034，P =0.042）。治疗后，两组患者尿浊、神疲畏寒、小便清长或短少、舌下静脉迂曲积分、中医证候总积分、空腹血糖、餐后2 h血糖、HbA1c、BUN、24 h尿蛋白定量、MDA、IL-6、IL-8、TNF-α、hs-CRP分别低于同组治疗前，SOD分别高于同组治疗前，且研究组尿浊、神疲畏寒、小便清长或短少、舌下静脉迂曲积分、中医证候总积分、空腹血糖、餐后2 h血糖、HbA1c、BUN、24 h尿蛋白定量、MDA、IL-6、IL-8、TNF-α、hs-CRP低于对照组，SOD高于对照组（P ＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（χ2=0.543，P =0.461）。结论　采用温脾补肾泄浊汤联合厄贝沙坦治疗糖尿病肾病临床疗效确切，有利于缓解患者的不适症状，改善其血糖、肾功能、氧化应激指标，抑制炎性反应，且未增加患者的不良反应，临床应用价值较高。

Abstract：

Objective　To investigate the efficacy of Wenpi Bushen Xiezhuo decoction combined with irbesartan inthe treatment of diabetic nephropathy. Methods　A total of 100 diabetic nephropathy patients in Department of Endocrinologyin the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine from June 2021 to January 2022 wereselected as the study subjects. They were divided into control group and research group by random number table method, 50 casesin each group. Both groups were given exercise and diet guidance and routine western medicine treatment. On this basis, thecontrol group was treated with oral irbesartan tablet, and the research group was treated with Wenpi Bushen Xiezhuo decoctionon the basis of the control group. Both groups were treated for 2 months. The clinical efficacy after treatment, TCM syndromescores, blood glucose [fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin (HbA1c) ] , renal functionindexes [blood urea nitrogen (BUN) , 24-hour urine protein quantification] , oxidative stress indexes [superoxide dismutase (SOD) ,malondialdehyde (MDA) ] and inflammatory factors [IL-6, IL-8, tumor necrosis factor-α (TNF-α) , hypersensitive C-reactiveprotein (hs-CRP) ] before treatment and after treatment of the two groups were compared. The adverse reactions of the two groupswere recorded. Results　The clinical efficacy of the research group was better than that of the control group (u =2.034, P =0.042) .The scores of urine turbid, mental fatigue and chills, long or short urination and sublingual vein tortuosity, total score of TCMsyndrome scores, fasting blood glucose, 2 h postprandial blood glucose, HbA1c, BUN, 24-hour urine protein quantification, MDA,IL-6, IL-8, TNF-α, hs-CRP after treatment in the control group and the research group were lower than those before treatment,respectively, SOD after treatment in the control group and the research group was higher than that before treatment, respectively (P< 0.05) . After treatment, the scores of urine turbid, mental fatigue and chills, long or short urination and sublingual vein tortuosity,total score of TCM syndrome scores, fasting blood glucose, 2 h postprandial blood glucose, HbA1c, BUN, 24-hour urine proteinquantification, MDA, IL-6, IL-8, TNF-α, hs-CRP in the research group were lower than those in the control group, SOD in theresearch group was higher than that in the control group (P < 0.05) . There was no significant difference in the incidence of adversereactions between the two groups (χ2=0.543, P =0.461) . Conclusion　The clinical efficacy of Wenpi Bushen Xiezhuo decoctioncombined with irbesartan in the treatment of diabetes nephropathy is significant. It is conducive to alleviate the discomfortsymptoms of patients, improve their blood glucose, renal function, oxidative stress indexes, inhibit inflammatory reactions, anddoes not increase the adverse reactions of patients. It has high clinical application value.

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