CAJ | 학술논문

目的：观察糖肾康煎剂与羟苯磺酸钙分散片联合黄芪及疏血通注射液治疗糖尿病肾脏疾病 IV 期的临床疗效。方法：选取确诊的糖尿病肾脏疾病 IV 期患者96例，随机分为对照组和治疗组各48例。2组均给予胰岛素控制血糖，替米沙坦和硝苯地平缓释片控制血压，黄芪注射液和疏血通注射液静脉滴注，治疗组加用羟苯磺酸钙分散片和糖肾康煎剂口服。病程均为14 d。观察治疗前后临床症状、24 h 尿白蛋白定量、血脂和肾功能等指标的变化。结果：2组治疗后较治疗前各项检验指标及临床症状评分均有不同程度下降，但治疗组治疗后临床疗效总有效率为93.75％，对照组总有效率为68.8％，组间比较有统计学意义（P ＜0.05）。临床主要症状评分2组治疗后较治疗前虽均有改善，但对照组改善不明显（P ＞0.05），治疗组改善明显（P ＜0.05），治疗组优于对照组（P ＜0.05）。24 h 尿蛋白定量、TC、TG、BUN、Scr 等主要生化指标2组治疗后较治疗前均有不同程度降低，但治疗组显著下降（P ＜0.05），对照组下降不显著（P ＞0.05），2组比较差异有统计学意义（P ＜0.05）。结论：糖肾康煎剂与羟苯磺酸钙分散片联合黄芪及疏血通注射液治疗糖尿病肾病 IV 期临床疗效确切。特别是改善临床症状，减少尿蛋白排泄，改善肾脏微循环，促进肾血流，恢复肾功能，从而达到有效阻断或逆转病程进展速度，为糖尿病肾病优化组合治疗方案开辟了一条新途径。
목적：관찰당신강전제여간분광산개분산편연합황기급소혈통주사액치료당뇨병신장질병 IV 기적림상료효。방법：선취학진적당뇨병신장질병 IV 기환자96례，수궤분위대조조화치료조각48례。2조균급여이도소공제혈당，체미사탄화초분지평완석편공제혈압，황기주사액화소혈통주사액정맥적주，치료조가용간분광산개분산편화당신강전제구복。병정균위14 d。관찰치료전후림상증상、24 h 뇨백단백정량、혈지화신공능등지표적변화。결과：2조치료후교치료전각항검험지표급림상증상평분균유불동정도하강，단치료조치료후림상료효총유효솔위93.75％，대조조총유효솔위68.8％，조간비교유통계학의의（P ＜0.05）。림상주요증상평분2조치료후교치료전수균유개선，단대조조개선불명현（P ＞0.05），치료조개선명현（P ＜0.05），치료조우우대조조（P ＜0.05）。24 h 뇨단백정량、TC、TG、BUN、Scr 등주요생화지표2조치료후교치료전균유불동정도강저，단치료조현저하강（P ＜0.05），대조조하강불현저（P ＞0.05），2조비교차이유통계학의의（P ＜0.05）。결론：당신강전제여간분광산개분산편연합황기급소혈통주사액치료당뇨병신병 IV 기림상료효학절。특별시개선림상증상，감소뇨단백배설，개선신장미순배，촉진신혈류，회복신공능，종이체도유효조단혹역전병정진전속도，위당뇨병신병우화조합치료방안개벽료일조신도경。
Objective:To observe the clinical effect of Tangshenkang decoction combined with calcium dobesilate dispersible tablets and Astragalus and Shuxuetong injection in treatment of phase IV diabetic nephropathy.Methods:Ninety six patients with phase IV diabetic renal disease were randomly divided into control group (n =48)and treatment group (n =48).Patients in both groups were given insu-lin to control blood sugar,telmisartan and nifedipine tablets to control blood pressure,as well as astragalus injection and Shuxuetong in-jection.Besides,patients in the treatment group were given dispersible tablets and Tangshenkang decoction with calcium dobesilate.The treatment course was 14 days.The changes of clinical symptoms,24 h urinary albumin excretion,blood lipid and renal function were ob-served before and after treatment.Results:All indexes and clinical symptom score of patients in both groups after treatment were de-creased.The total effective rate of treatment group was 93.75%,while that of the control group was 68.8%,and the difference between the two groups was significant (P <0.05).The main clinical symptom score of patients in both groups were improved after treatment, but the control group had no obvious improvement (P >0.05),while the treatment group showed significant improvement (P <0.05). The main biochemical index of 24 h urinary protein,TC,TG,BUN,Scr were reduced to various degrees after treatment,and the treat-ment group decreased significantly (P <0.05),while the decrease in the control group was not significant (P >0.05),so there was significant difference between the two groups (P <0.05).Conclusion:Tangshenkang decoction combined with calcium dobesilate dis-persed tablets and Astragalus shows definite clinical efficacy in the treatment of phase IV diabetic nephropathy.The therapy can improve clinical symptoms,reduce urinary protein excretion,improve renal microcirculation,promote the recovery of renal function,promote re-nal blood flow,so as to effectively block or reverse the disease progression,open up a new way for the optimization and combination ther-apy of diabetic nephropathy.