目的：观察自拟益气养阴活血通络方对糖尿病肾病（ DN）Ⅳ期患者临床疗效及炎性因子的影响。方法选取2014年1月—2016年1月石家庄市中医院肾内科60例Ⅳ期DN患者作为研究对象。随机数字表法分为研究组和对照组，均予糖尿病教育，低盐低脂低糖饮食，适量运动，基础药物控制血糖、血压达标。对照组予厄贝沙坦口服，研究组在此基础上辨证加用自拟益气养阴活血通络方口服，治疗3个月后，比较2组临床疗效及治疗前后24 h尿蛋白定量（24hUP）、血肌酐（SCr）、尿素氮（BUN）、炎性因子的变化。结果研究组总有效率为86帋．7％，明显高于对照组的56．7％（χ2＝6．975， P ＜0．05）。与治疗前比较，2组24hUP、血清BUN、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子（TNF-α），白介素6（IL-6）均明显降低，差异有统计学意义（ t 对照组＝6．944、2．211、2．623、5．431、6．181；t 研究组＝7．032、8．683、4．519、4．372、7．162， P均＜0．05），而血清SCr均无明显变化，差异无统计学意义（ t ＝0．533、0．546， P ＞0．05）；与对照组治疗后比较，研究组24hUP、血清BUN、hs-CRP、TNF-α、IL-6均显著降低，差异有统计学意义（ t ＝2．661、5．461、4．382、7．222、5．352， P ＜0．05），血清SCr比较差异无统计学意义（ t ＝0．192， P ＞0．05）。结论自拟益气养阴活血通络方可以明显减少DN患者尿蛋白排泄，保护肾功能，调节炎性介质，明显提高临床疗效。%Objective To observe the effect of Yiqiyangyinhuoxuetongluo decoction on clinical curative effect and in-fluence of inflammatory factors in diabetic nephropathy ( DN) patients with stage IV .Methods From January 2014 to January 2016 , 60 cases of DN patients in Shijiazhuang Hospital of traditional Chinese medicine were selected as the research object . The random number table method is divided into 2 groups of research group and control group , patients treatment with diabetes education , low salt low fat low sugar diet , moderate exercise , basic medicine control blood sugar , blood pressure standards . Patients in control group were treated with irbesartan tablets for oral treatment , research group based on syndrome differentia-tion plus oral medicine , treatment for 3 months, compared with two groups before and after treatment and between the two groups of the clinical efficacy, 24h urinary total protein (24h UTP), SCr, BUN and inflammatory factors.Results The study group total effective rate was 86.7%, which was higher than the control group 56.7%(χ2 =6.975, P <0.05).Compared with before treatment, two groups of 24h UTP, serum blood urea nitrogen (BUN), high sensitive C reactive protein (hs-CRP) and tumor necrosis factor (TNF-a), interleukin 6 (IL-6) were significantly lower, the difference is statistically significant (control group:t =6.944, t =2.211, t =2.623, t =5.431, t =6.181; study group:t =7.032, t =8.683, t =4.519, t =4.372, t =7.162, P <0.05), while serum SCr without significant change , the difference was not statistically significant ( t =0.533, t =0.546, P >0.05).Compared with the control treatment group , 24h UTP in the study group, serum BUN, hs-CRP, TNF-a, IL-6 decreased significantly , the difference was statistically significant ( t =2.661, t =5.461, t =4.382, t =7.222, t =5.352, P <0.05), the differences in the levels of Scr no statistical significance ( t =0.192, P >0.05). Conclusion Yiqiyangyinhuoxuetongluo decoction can significantly reduced DN patients'urinary protein excretion ,protect renal function, regulation of inflammatory mediators and significantly improve the clinical efficacy .
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