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目的:观察中药益肾通络汤对糖尿病肾病(DN)的治疗效果。方法:将142例DN患者随机双盲分为3组,对照组40例单纯采用西医糖尿病基础治疗,治疗A组50例在对照组治疗的基础上加用银杏达莫粉针液,静脉滴注4周;治疗B组52例在对照组治疗的基础上加用黄芪注射液静脉滴注4周,中药益肾通络汤内服,1剂/d,水煎早晚分服,14 d为1个疗程,连用2个疗程。治疗后观察患者的临床疗效及空腹血糖(FBG),餐后血糖(PBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醉(LDL-L),高密度脂蛋白胆固醉(HDL-L),24 h尿白蛋白定量,尿白蛋白排泄率(UAER)及尿β2微球蛋白(尿β2-MG),尿素氮(BUN),血肌酐(SCr),内生肌酐清除率(CCr),糖化血红蛋白(Hb A1c),血浆同型半胱氨酸(Hcy),颈动脉中层内膜厚度(颈动脉IMT)等指标。结果:治疗A组50例中,显效17例,有效17例,无效16例,总有效率68.0%。治疗B组52例中,显效37例,有效8例,无效7例,总有效率86.5%。对照组40例中,显效8例,有效14例,无效18例,总有效率55.0%。3组有效率相比,有显著性差异(P<0.01)。治疗B组与治疗A组比较,差异均有统计学意义(P<0.05)。结论:银杏达莫注射液可减少尿微量白蛋白,具有改善血液流变学作用,从而延缓DN的发展,对DN有治疗和保护作用。黄芪联合中药益肾通络汤治疗糖尿病肾病疗效更加显著,明显改善症状及减少尿蛋白,能保护肾功能,延缓肾功能衰竭的发生及发展,疗效确切,值得推广。
Objective: To observe the therapeutic effect of Yishen Tongluo Decoction on diabetic nephropathy (DN). Methods: One hundred and twenty-two patients with DN were randomly divided into three groups. Forty patients in the control group were treated with western medicine based on simple diabetes mellitus. Fifty patients in group A were treated with ginkgo diphenhydramine solution intravenously 4 weeks; treatment group B 52 cases in the control group based on the treatment with Astragalus injection intravenous infusion for 4 weeks, Chinese medicine Yishen Tongluo decoction, 1 / d, decoction morning and evening, 14 d was 1 Course of treatment, once every 2 courses. After treatment, the clinical efficacy, fasting blood glucose (FBG), postprandial blood glucose (PBG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-L) (HDL-L), urine 24 h urinary albumin, urinary albumin excretion rate (UAER) and urinary β2 microglobulin (BUN), serum creatinine (SCr) Endogenous creatinine clearance rate (CCr), Hb A1c, plasma homocysteine (Hcy), carotid artery intima-media thickness (carotid IMT) and other indicators. Results: Among the 50 cases in group A, 17 cases were markedly effective, 17 cases were effective, 16 cases were ineffective and the total effective rate was 68.0%. Among 52 cases in treatment group B, 37 cases were markedly effective, 8 effective and 7 ineffective, with a total effective rate of 86.5%. Control group 40 cases, markedly effective in 8 cases, effective in 14 cases, 18 cases ineffective, the total effective rate was 55.0%. There was significant difference between the three groups (P <0.01). Treatment B group and treatment A group, the difference was statistically significant (P <0.05). Conclusion: Ginkgo biloba injection can reduce urinary microalbumin, improve hemorrheology, delay the development of DN and treat and protect DN. Astragalus combined with Yisheng Tongluo decoction treatment of diabetic nephropathy more significant effect, significantly improve symptoms and reduce proteinuria, can protect renal function, delay the occurrence and development of renal failure, the exact effect, it is worth promoting.