2023 年第 6 期 第 18 卷

益气养阴化瘀方加减治疗早期糖尿病肾病效果及对患者炎性指标和高凝状态的影响

Effect of modified Yiqi Yangyin Huayu recipe on early diabetic nephropathy and its influence on inflammatory indicators and hypercoagulabilit

作者：都宾宾1李松林2朱俊霞1陈纳贝3张晶4

英文作者：yDu Binbin1 Li Songlin2 Zhu Junxia1 Chen Nabei3 Zhang Jing4

单位：1广州中医药大学第一附属医院内分泌科，广州510000；2广东省深圳市第三人民医院中医理疗科，深圳518112；3中山大学孙逸仙纪念医院深汕中心医院中医科，汕尾516600；4广东省深圳市第三人民医院全科医学科，深圳518112

英文单位：1Department of Endocrinology First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine Guangzhou 510000 China; 2Department of Traditional Chinese Medicine Physiotherapy the Third People′s Hospital of Shenzhen Guangdong Province Shenzhen 518112 China; 3Department of Traditional Chinese Medicine Shenshan Medical Center Memorial Hospital of Sun Yat-Sen University Shanwei 516600 China; 4Department of General Medicine the Third People′s Hospital of Shenzhen Guangdong Province Shenzhen 518112 China

关键词：早期糖尿病肾病；益气养阴化瘀方；炎性指标；高凝状态

英文关键词：Earlydiabeticnephropathy;YiqiYangyinHuayurecipe;Inflammatoryindicators;Hypercoagulability

• 摘要：

• 目的  探讨益气养阴化瘀方加减在早期糖尿病肾病（气阴两虚、瘀血阻络型）患者治疗中的应用价值，观察其对患者炎性指标、高凝状态的影响。方法  选取2020年1月至2022年8月因早期糖尿病肾病（气阴两虚、瘀血阻络型）于广州中医药大学第一附属医院和广东省深圳市第三人民医院门诊及住院的80例患者，采用随机数字表法分为对照组和观察组，各40例。对照组采用常规西医治疗，观察组在对照组基础上联合益气养阴化瘀方加减口服治疗，2组均治疗12周。比较2组治疗前后转化生长因子β1（TGF-β1）、胱抑素C、白细胞介素18（IL-18）、高敏C反应蛋白（hs-CRP）、24 h尿蛋白、血肌酐、D-二聚体、纤维蛋白原水平和临床疗效。结果  2组治疗后TGF-β1、胱抑素C、IL-18、hs-CRP、24 h尿蛋白、血肌酐、D-二聚体、纤维蛋白原水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。观察组总有效率高于对照组［95.0%（38/40）比72.5%（29/40）］，差异有统计学意义（P=0.006）。结论  益气养阴化瘀方加减可以有效治疗早期糖尿病肾病（气阴两虚、瘀血阻络型），减轻炎症反应，改善高凝状态。

• Objective    To explore the application value of the modified Yiqi Yangyin Huayu recipe in the treatment of early diabetic nephropathy (deficiency of both Qi and Yin, blood stasis blocking collaterals types), and to observe its effect on inflammatory indicators and hypercoagulability. Methods  From January 2020 to August 2022, 80 patients admitted to First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the Third People′s Hospital of Shenzhen, Guangdong Province due to early diabetic nephropathy (deficiency of both Qi and Yin, blood stasis blocking collaterals types) were selected. They were divided into control group and observation group by the random number table method, with 40 cases in each group. The control group was treated with western medicine, while the observation group was treated with modified  Yiqi Yangyin Huayu recipe on the basis of the control group. Both of them were treated for 12 weeks. The levels of transforming growth factor-β1 （TGF-β1）, cystatin C, interleukin-18 (IL-18), high-sensitivity C-reactive protein (hs-CRP), 24-h urinary protein, serum creatinine, D-dimer, fibrinogen before and after treatment and clinical effects were compared between the two groups. Results  The levels of TGF-β1, cystatin C, IL-18, hs-CRP, 24-h urine protein, serum creatinine, D-dimer, and fibrinogen after treatment in the two groups were lower than those before treatment, and all of them in the observation group were lower than those in the control group (all P＜0.05). The total effective rate in the observation group was higher than that in the control group ［95.0%(38/40) vs 72.5%(29/40)］(P=0.006). Conclusion  The modified Yiqi Yangyin Huayu recipe can effectively treat early diabetic nephropathy(deficiency of both Qi and Yin, blood stasis blocking collaterals types), reduce the inflammatory response, and decrease hypercoagulability.