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目的:观察黄芪生脉饮与复方丹参片联合常规疗法治疗早期2型糖尿病肾病的效果。方法:将87例早期2型糖尿病肾病气阴两虚兼血瘀型患者分为对照组42例和治疗组45例,2组均进行糖尿病教育、饮食控制、运动及常规降糖治疗,治疗组同时予以黄芪生脉饮联合复方丹参片治疗,疗程为12周,观察治疗前后2组患者的血糖、血小板参数、同型半胱氨酸(Hcy)、肾功能指标的变化。结果:治疗后,2组空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)均较治疗前下降(P<0.05);2组各指标比较,差异均无统计学意义(P>0.05)。2组平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)均较治疗前下降(P<0.01,P<0.05),治疗组MPV、PDW均低于对照组(P<0.05)。治疗组Hcy较治疗前下降(P<0.05),对照组无明显变化(P>0.05);治疗组Hcy低于对照组(P<0.05)。2组尿白蛋白排泄率(UAER)均较治疗前改善(P<0.01),治疗组UAER低于对照组(P<0.05);治疗组内生肌酐清除率(CCr)较治疗前亦有明显改善(P<0.05),而对照组CCr较治疗前无明显改善(P>0.05),治疗组CCr高于对照组(P<0.05)。结论:在西医常规疗法基础上加用黄芪生脉饮联合复方丹参片治疗早期2型糖尿病肾病气阴两虚兼血瘀型患者可保护肾脏的血管功能,改善微循环,起到良好的降低尿白蛋白、提高肾功能的作用,安全有效。
Objective: To observe the effect of combining Astragalus Sheng Mai Yin and Fufang Danshen Tablets in the treatment of early type 2 diabetic nephropathy. Methods: Eighty-eight cases of type 2 diabetic nephropathy with deficiency of both qi and yin and blood stasis type were divided into control group (n = 42) and treatment group (n = 45). The two groups were given diabetes education, diet control, exercise and conventional hypoglycemic treatment. At the same time to be combined Astragalus Shengmai Decoction of danshen tablets, treatment for 12 weeks, before and after treatment in patients with two groups of blood glucose, platelet parameters, homocysteine (Hcy), renal function changes. Results: After treatment, FBG, P2hBG and HbA1c in two groups were significantly lower than those before treatment (P <0.05). There was no significant difference in each index between the two groups (P> 0.05). The MPV, PCT and PDW of the two groups were lower than those before treatment (P <0.01, P <0.05). The MPV and PDW of the two groups were lower than those of the control group (P < 0.05). The Hcy in the treatment group was lower than that before treatment (P <0.05), but there was no significant difference in the control group (P> 0.05). The Hcy in the treatment group was lower than that in the control group (P <0.05). The urinary albumin excretion rate (UAER) of the two groups were improved compared with those before treatment (P <0.01), and the UAER of the treatment group was lower than that of the control group (P <0.05). The CCr of the treatment group was also significantly higher than that before treatment (P <0.05), while the CCr in the control group had no significant improvement (P> 0.05). The CCr in the treatment group was higher than that in the control group (P <0.05). Conclusion: The combination of Astragalus Shengmai Decoction and Fufang Danshen Tablets in the treatment of early type 2 diabetic nephropathy based on the conventional treatment of Western medicine can protect the function of kidney, improve the microcirculation, and reduce the urine Albumin, improve renal function, safe and effective.