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目的:观察益气化瘀汤联合西药治疗早期糖尿病肾病的疗效及对血管内皮功能的影响。方法:将106例早期糖尿病肾病气阴两虚兼血瘀证患者随机分为西医组和观察组各53例。西医组给予控制血糖、改善生活方式、控制血压、调脂、饮食干预等综合措施,并口服缬沙坦片治疗。观察组在西医组治疗基础上加服益气化瘀汤治疗。2组疗程均为3月。检测2组患者治疗前后的空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿素氮(BUN)、血肌酐(SCr)、24 h尿蛋白定量(24h Upr)、一氧化氮(NO)和内皮素-1(ET-1)水平,比较2组的临床疗效与中医证候疗效。结果:临床疗效观察组总有效率为67.92%,高于西医组的45.28%,差异有统计学意义(P<0.05)。中医证候疗效观察组总有效率为84.91%,高于西医组的66.04%,差异有统计学意义(P<0.05)。2组FBG治疗前后比较,差异均无统计学意义(P>0.05)。治疗后,2组HbA1c、24h Upr、BUN和SCr水平均较治疗前下降(P<0.01),观察组HbA1c、24h Upr、BUN和SCr水平均低于西医组(P<0.01)。2组血清ET-1均较治疗前下降(P<0.01),NO水平均较治疗前升高(P<0.01);观察组ET-1水平低于西医组(P<0.01),NO水平高于西医组(P<0.01)。结论:在西医常规疗法基础上加用益气化瘀汤治疗早期糖尿病肾病气阴两虚兼血瘀证,能有效改善患者的临床症状,减轻蛋白尿,并能改善血管内皮功能,延缓肾功能的损害,临床疗效显著。
Objective: To observe the therapeutic effect of Yiqi Huayu decoction combined with western medicine on early diabetic nephropathy and its effect on vascular endothelial function. Methods: 106 patients with early diabetic nephropathy Qi-Yin Deficiency and Blood Stasis syndrome were randomly divided into Western medicine group and observation group of 53 cases. Western medicine group to give control of blood sugar, improve lifestyle, control blood pressure, lipid regulation, diet intervention and other comprehensive measures, and oral valsartan tablets treatment. The observation group in the Western medicine group based on the treatment of Yi Qi Huayu Tang treatment. The two groups were treated in March. The levels of fasting blood glucose (FBG), HbA1c, BUN, SCr, 24h Upr, NO and ET before and after treatment were measured in two groups before and after treatment. -1 (ET-1) levels were compared between the two groups of clinical efficacy and efficacy of TCM syndromes. Results: The total effective rate in clinical observation group was 67.92%, which was higher than that in Western medicine group (45.28%), the difference was statistically significant (P <0.05). The total effective rate of TCM syndrome observation group was 84.91%, higher than that of Western medicine group (66.04%), the difference was statistically significant (P <0.05). There was no significant difference between the two groups before and after FBG treatment (P> 0.05). After treatment, the levels of HbA1c, 24h Upr, BUN and SCr in two groups were significantly lower than those before treatment (P <0.01). The levels of HbA1c, 24h Upr, BUN and SCr in observation group were lower than those in Western medicine group (P <0.01). The levels of ET-1 in the two groups were significantly lower than those before the treatment (P <0.01), while the levels of NO in the two groups were significantly higher than those before treatment (P <0.01) Western medicine group (P <0.01). Conclusion: The combination of Yiqi Huayu Decoction with traditional Chinese medicine in the treatment of early diabetic nephropathy with deficiency of both qi and yin and blood stasis syndrome can effectively improve the clinical symptoms, reduce proteinuria, and improve vascular endothelial function and delay renal function Damage, significant clinical effect.