CAJ | 학술논문

目的：观察中西药联合序贯疗法与非序贯疗法治疗临床期气阴两虚兼血瘀型糖尿病肾病（ DN）的临床疗效。方法选择2008年1月-2012年12月医院收治的气阴两虚兼血瘀型DN患者80例，根据不同治疗方法，将其分为序贯组39例与非序贯组41例，比较2组临床疗效及中医证候疗效，观察2组治疗前后24h尿蛋白定量、尿微量白蛋白／尿肌酐比值（ MA／Cr）及肾小球滤过率（ eGFR）。结果序贯组在西医临床疗效及中医证侯改善方面均明显优于非序贯组，序贯组治疗后24h尿蛋白明显低于治疗前及非序贯组，差异均有统计学意义（ P﹤0.05）。非序贯组24h尿蛋白治疗前后比较差异无统计学意义（ P﹥0.05）。2组治疗后与治疗前比较尿MA／Cr差异无统计学意义（ P﹥0.05）。治疗后2组eGFR均有所下降，但序贯组治疗前后差异无统计学意义（ P﹥0.05），非序贯组前后差异有统计学意义（P﹤0.05）。结论序贯疗法较非序贯疗法能达到更好的临床疗效及临床中医证候的改善，更好地控制糖尿病肾病eGFR的下降，有效减少24h尿蛋白。
목적：관찰중서약연합서관요법여비서관요법치료림상기기음량허겸혈어형당뇨병신병（ DN）적림상료효。방법선택2008년1월-2012년12월의원수치적기음량허겸혈어형DN환자80례，근거불동치료방법，장기분위서관조39례여비서관조41례，비교2조림상료효급중의증후료효，관찰2조치료전후24h뇨단백정량、뇨미량백단백／뇨기항비치（ MA／Cr）급신소구려과솔（ eGFR）。결과서관조재서의림상료효급중의증후개선방면균명현우우비서관조，서관조치료후24h뇨단백명현저우치료전급비서관조，차이균유통계학의의（ P﹤0.05）。비서관조24h뇨단백치료전후비교차이무통계학의의（ P﹥0.05）。2조치료후여치료전비교뇨MA／Cr차이무통계학의의（ P﹥0.05）。치료후2조eGFR균유소하강，단서관조치료전후차이무통계학의의（ P﹥0.05），비서관조전후차이유통계학의의（P﹤0.05）。결론서관요법교비서관요법능체도경호적림상료효급림상중의증후적개선，경호지공제당뇨병신병eGFR적하강，유효감소24h뇨단백。
Objective To analyze the clinical efficacy of traditional Chinese medicine and Western medicine sequen-tial therapy in treatment of clinical stage diabetic nephropathy( DN). Methods selected 80 cases of patients with DN in the hospital from January 2008 to December 2012. Depending on the method of treatment,divided into sequential group(39 cases) and non-sequential group(41 cases). Compared the clinical efficacy and TCM syndromes of two groups,observed the 24h uri-nary protein,urinary albumin/urine creatinine ratio( MA/Cr)and glomerular filtration rate( eGFR)before and after the treat-ment of two groups. Results The Western medicine clinical efficacy and TCM symptoms improve respect of sequential group were significantly better than non-sequential group;After treatment the 24h urine protein of sequential group was significantly lower than before treatment and non-sequential group,the differences were statistically significant(P﹤0. 05). Non-sequential group 24h urine protein before and after treatment showed no significant difference(P﹥0. 05). The urinary MA/Cr of two groups before and after the treatment was no significant difference(P﹥0. 05). After treatment,the eGFR of two groups were decreased,but the difference of sequential group before and after the treatment was not statistically significant(P﹥0. 05),the difference of non-sequential group before and after the treatment was statistically significant(P﹤0. 05). Conclusion sequen-tial therapy compared with non-sequential therapy can achieve better clinical efficacy and improve clinical syndromes,better control of diabetic nephropathy eGFR decline,effectively reducing the 24h urine protein.