羅屏 譚海燈 曾富元

摘要：目的?評價溫腎補氣活血方治療糖尿病腎病Ⅲ期的臨床療效與藥物安全性。方法?將60例患者隨機分為對照組與觀察組各30例，所有患者均予基礎的治療方案，將血糖、血壓、血脂控制在合理范圍，觀察組另予口服溫腎補氣活血方治療，3個月后進行觀察指標評定。結果?與治療前對比，2組患者的UACR、BUN、Scr均顯著改善（P<0.05），且觀察組較對照組改善明顯（P<0.05）;與治療前對比，2組患者的eGFR均有所上升（P<0.05），觀察組較對照組的eGFR上升程度更為顯著（P<0.05）;不良反應發(fā)生率方面，觀察組為6.67%，對照組對16.67%，2組對比（P<0.05）。結論?嚴格控制血糖、血壓、血脂等基礎治療有利于延緩糖尿病腎病的進程，而溫腎補氣活血方在改善脾腎陽虛兼血瘀證患者腎功能方面效果顯著，有效延緩腎功能衰竭的進程，改善疾病的預后，且藥物安全性高，值得臨床推廣。

關鍵詞：糖尿病腎?、笃?溫腎補氣活血方;腎功能;藥物安全性

中圖分類號：R587.2?文獻標志碼：B?文章編號：1007-2349（2020）08-0026-04

【Abstract】Objective： To evaluate the clinical effect and drug safety of Wenshen Buqi Huoxue Prescription in the treatment of diabetic nephropathy patients （stage Ⅲ）.?Methods： 60 patients were randomly divided into a control group and an observation group， 30 cases per group.?All patients were given basic treatment plan to control blood glucose， blood pressure and blood lipid within a reasonable range and the observation group was added oral Wenshen Buqi Huoxue Prescription.?The observation index was evaluated 3 months later.?Results： In comparison with those of the pre-treatment， the UACR， BUN and Scr of the two groups were significantly improved （P<0.05）.?The observation group was significantly better than the control group （P<0.05）.?Compared with that of the pre-treatment， the eGFR of the two groups were increased and the eGFR in the observation group was more significant than that in the control group （P<0.05）.The incidence of adverse reactions was 6.67% in the observation group and 16.67% in the control group （P<0.05）.?Conclusion： The strict control of blood glucose， blood pressure and blood lipids is beneficial to delay the progression of diabetic nephropathy and Wenshen Buqi Huoxue Prescription is effective in improving the renal function of patients with spleen and kidney yang deficiency and blood stasis syndrome， and effectively delays the progression of renal failure， improve the prognosis of the disease， and the drug has high safety and is worthy of clinical application.

【Key words】diabetic nephropathy （stage Ⅲ）， Wenshen Buqi Huoxue Prescription， renal function， drug safety

糖尿病腎病（Diabetic NePhroPathy，DN），是糖尿病常見的嚴重慢性微血管并發(fā)癥[1]，臨床多表現為持續(xù)的蛋白尿、水腫、腎性高血壓等，嚴重者可導致死亡[2]。近年來由于我國經濟迅速發(fā)展、居民飲食結構的改變、對疾病的重視程度提高，2型糖尿病的發(fā)病率逐年上升[3]，而糖尿病腎病已成為我國引起終末期腎病的首要病因[4]。中醫(yī)雖無糖尿病腎病的病名，根據其癥狀、體征，歸于“消渴”、“水腫”、“尿濁”、“關格”等范疇，中醫(yī)的辨證施治、“未病先防，既病防變”的治未病思想、整體觀等核心觀念在治療糖尿病腎病體現出了極大的優(yōu)勢，前景可觀[5]。本研究選用的溫腎補氣活血方對脾腎陽虛兼血瘀的糖尿病腎?、笃诨颊哌M行中醫(yī)藥干預，臨床療效滿意，藥物安全性高，現報道如下。