2023 年第 10 期 第 18 卷

洋参御唐方联合百令胶囊对糖尿病肾病Ⅳ期患者的临床疗效及对糖脂代谢和免疫功能的影响

The clinical efficacy of Yangshen Yutang recipe combined with Bailing capsule in the treatment of patients with diabetic nephropathy stage Ⅳ and its effects on glucose and lipid metabolism and immune function

作者：

英文作者：Chen Xin1 Zhao Dapeng2 Jiang Yanan1 Han Lijun1

单位：1黑龙江中医药大学，哈尔滨150040；2黑龙江中医药大学附属第一医院肾病一科，哈尔滨150040

英文单位：1Heilongjiang University of Chinese Medicine Harbin 150040 China; 2First Department of Nephrology First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin 150040 China

关键词：糖尿病肾病；洋参御唐方；肾功能；糖脂代谢；免疫功能

英文关键词：Diabeticnephropathy;YangshenYutangrecipe;Kidneyfunction;Glucoseandlipidmetabolism;Immunefunction

• 摘要：

• 目的  探讨洋参御唐方联合百令胶囊对糖尿病肾病（DN）Ⅳ期患者的临床疗效及对糖脂代谢和免疫功能的影响。方法  选择2021年11月至2022年11月黑龙江中医药大学附属第一医院收治的60例DN Ⅳ期脾肾气虚血瘀证患者，按照随机数字表法分为对照组、观察组，各30例。对照组在常规治疗基础上加用百令胶囊治疗；观察组在对照组基础上加用洋参御唐方治疗。2组均连续治疗8周。比较2组临床疗效，治疗前后中医证候积分、肾功能、糖脂代谢、免疫功能指标，观察治疗过程中不良反应发生情况。结果  观察组显效23例、有效5例、无效2例，对照组显效12例、有效11例、无效7例。观察组疗效优于对照组，差异有统计学意义（P＜0.05）。治疗后，观察组、对照组中医证候积分均低于治疗前［（11±4）分比（28±6）分、（15±5）分比（28±6）分］，且观察组低于对照组(均P＜0.05)。治疗后2组患者血肌酐、血尿素氮、尿白蛋白排泄率、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、补体C3水平均低于治疗前，且观察组均低于对照组(均P＜0.05)。治疗后2组免疫球蛋白G水平均高于治疗前，且观察组高于对照组(均P＜0.05)。治疗过程中2组均未出现恶心呕吐、发热、食欲减退、腹泻等不良反应。结论  洋参御唐方联合百令胶囊治疗DN Ⅳ期患者效果显著且安全性较好，并且可有效改善患者肾功能、糖脂代谢及免疫水平。

• Objective  To explore the clinical efficacy of Yangshen Yutang recipe combined with Bailing capsule in the treatment of patients with stage Ⅳ diabetic nephropathy (DN), as well as its effects on glucose and lipid metabolism and immune function. Methods  Sixty patients with stage Ⅳ DN of spleen kidney qi deficiency and blood stasis syndrome admitted to First Affiliated Hospital, Heilongjiang University of Chinese Medicine from November 2021 to November 2022 were enrolled. They were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with Bailing capsule on the basis of routine treatment; the observation group was treated with Yangshen Yutang recipe on the basis of the control group. Both groups were treated continuously for 8 weeks. The clinical efficacy of two groups, including traditional Chinese medicine (TCM) syndrome scores, renal function, glucose and lipid metabolism, and immune function indicators before and after treatment were compared, and the occurrence of adverse reactions during the treatment process were observed. Results  In the observation group, there were 23 cases of significant improvement, 5 cases of effective treatment, and 2 cases of ineffective treatment, while in the control group, there were 12 cases of significant improvement, 11 cases of effective treatment, and 7 cases of ineffective treatment. The therapeutic effect of the observation group was better than that of the control group(P＜0.05). After treatment, the TCM syndrome scores of the observation group and the control group were lower than those before treatment［(11±4) vs (28±6), (15±5) vs (28±6)］, and the observation group was lower than the control group (all P＜0.05). After treatment, the levels of serum creatinine, blood urea nitrogen, urinary albumin excretion rates, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triacylglycerol, and complement C3 in both groups of patients were lower than before treatment, and the observation group was lower than the control group (all P＜0.05). After treatment, the immunoglobulin G levels in both groups were higher than before treatment, and the observation group was higher than the control group (all P＜0.05). During the treatment, neither group experienced any adverse reactions such as nausea, vomiting, fever, decreased appetite, or diarrhea. Conclusion  The combination of Yangshen Yutang recipe and Bailing capsule has a significant effect and good safety in the treatment of stage Ⅳ DN, and can effectively improve renal function, glucose and lipid metabolism, and immune levels.