中医辩证结合氯沙坦治疗糖尿病肾病的临床研究

摘要

Objective To study the effect of TCM syndrome differentiation combined with Losartan on diabetic nephropathy and renal function and blood lipid metabolism. Methods Both the control group and observation group were treated by the conventional hypoglycemic treatment, supplemented by diet and exercise treatment as well as maintained blood pressure stablely. In addition, the control group took Losartan one tablet once a day, and the observation group adopted TCM syndrome differentiation treatment based on the treatment given to the control group. And the clinical changes in urinary albumin excretion rate(UAER), serum creatinine(Cr), blood urea nitrogen(BuN), and renal function as well as the level of blood lipid metabolism were observed in both groups. Results The response rate was 91.11%(41/45) in the observation group, and that was 64.44%(29/45) in the control group, the difference in the clinical response rate between the two groups was statistically significant (P<0.05). The UAER, Cr and BuN in both groups showed significant reductions, but the reductions in the observation group were greater than those in the control group(P<0.05). Lipid metabolism index in both groups improved, but compared with the control group, the observation group had higher extent of high density lipoprotein increase and low density lipoprotein reduction with statistical significance(P<0.05). Conclusion For patients with diabetic nephropathy, TCM syndrome differentiation combined with Losartan has significant clinical effect, which can effectively improve the UAER, Cr and BUN, positively affect the renal function and blood lipid metabolism, therefore it is worthy of clinical application and promotion.%目的：研究中医辩证结合氯沙坦方案治疗糖尿病肾病的疗效及对肾功能和血脂代谢的影响。方法两组患者均采用常规降血糖治疗，同时辅助饮食与运动治疗，维持患者血压稳定。对照组患者采用氯沙坦[1次/(片·d)]治疗，观察组在对照组的基础上采用中医辩证方案辅助治疗，同时观察两组患者的尿蛋白排泄率(UAER)、血肌醉(Cr)和血尿素氮(BuN)的临床变化，以及对两组患者的肾功能和血脂代谢水平。结果两组患者临床有效率对比，观察组患者有效率为91.11%(41/45)，对照组患者有效率为64.44%(29/45)，两组患者对比差异有统计学意义(P<0.05)。两组患者的UAER、Cr和BuN均出现了明显的下降，且观察组明显优于对照组(P<0.05)。两组患者血脂代谢指标均有所改善，且观察组高密度脂蛋白提高与低密度脂蛋白降低优于对照组，差异有统计学意义(P<0.05)。结论中医辩证结合氯沙坦方案治疗糖尿病肾病临床效果显著，患者的UAER、Cr、BUN能够得到有效地改善，且对患者肾功能和血脂代谢具有正面影响作用，充分说明了中医辩证结合氯沙坦方案的临床效果，值得临床广为推广应用。