广西医学

目的探讨芪精地黄汤联合缬沙坦治疗阴阳两虚证G2A2期糖尿病肾病（DN)患者的临床效果。方法将72例阴阳两虚证G2A2期DN患者随机分为对照组和观察组，每组36例。在常规治疗基础上，给予对照组患者缬沙坦治疗，给予观察组患者芪精地黄汤联合缬沙坦治疗。比较两组患者治疗前及治疗12周后的中医证候积分、肾功能指标［尿白蛋白与肌酐比值（UACR）、估算肾小球滤过率（eGFR）］、血脂水平(总胆固醇、三酰甘油、LDL-C、HDL-C）、血糖控制相关指标（空腹血糖、餐后2 h血糖、HbA1c）、血压，以及治疗后中医临床疗效、治疗期间不良反应发生率。结果治疗后，两组的中医证候积分、UACR及血清总胆固醇、三酰甘油、LDL-C水平较治疗前降低，eGFR较治疗前升高，且观察组的上述指标优于对照组(P＜0.05）；两组患者的空腹血糖、餐后2 h血糖、HbA1c水平及血压较治疗前降低，血清HDL-C水平较治疗前升高（P＜0.05），但两组患者上述指标差异无统计学意义（P＞0.05）。观察组中医临床总有效率为91.7%，高于对照组的69.4%（P＜0.05)。两组患者治疗期间不良反应发生率差异无统计学意义（P＞0.05）。结论与单用缬沙坦相比，在常规治疗的基础上采用芪精地黄汤联合缬沙坦治疗可以更好地改善阴阳两虚证G2A2期DN患者的临床症状和肾功能，调节血脂水平，且安全性较好。

ObjectiveTo explore the clinical effect of Qijing Dihuang Decoction combined with valsartan for the treatment of patients with diabetic nephropathy (DN) with yin and yang deficiency in G2A2 stage. MethodsA total of 72 DN patients with yin and yang deficiency in G2A2 stage were randomly divided into control group or observation group, with 36 cases in each group. On the basis of routine treatment, the control group was treated with valsartan, while the observation group received Qijing Dihuang Decoction combined with valsartan for treatment. The pre- and 12-week post-treatment Traditional Chinese Medicine syndromes score, renal function indices (urinary albumin-to-creatinine ratio ［UACR］, estimated glomerular filtration rate ［eGFR］), blood lipid levels (total cholesterol, triglyceride, LDL-C, HDL-C), and indices related to blood glucose control (fasting blood glucose, 2-hour postprandial blood glucose, HbA1c), blood pressure, as well as clinical efficacy of Traditional Chinese Medicine after treatment, the incidence rate of adverse reactions during treatment were compared between patients of the two groups. ResultsAfter treatment, the Traditional Chinese Medicine syndromes score, UACR, and serum levels of total cholesterol, triglyceride, LDL-C of the two groups were decreased as compared with before treatment, whereas eGFR of the two groups was elevated as compared with before treatment, and the observation group exhibited superior aforesaid indices to compare with the control group (P＜0.05); furthermore, the levels of fasting blood glucose, 2-hour postprandial blood glucose, HbA1c, and blood pressure of the two groups were decreased as compared with before treatment, whereas serum HDL-C level of the two groups was elevated as compared with before treatment (P＜0.05); however, there was no statistically significant difference in indices as above between the two groups (P＞0.05). The observation group yielded a higher total clinical effective rate of Traditional Chinese Medicine as compared with the control group (91.7% vs. 69.4%, P＜0.05). No statistically significant difference in the incidence rate of adverse reactions during treatment was found between patients of the two groups (P＞0.05). ConclusionCompared with application of valsartan alone, employing Qijing Dihuang Decoction combined with valsartan based on routine treatment can preferably ameliorate clinical symptoms and renal function of DN patients with yin and yang deficiency in G2A2 stage, regulate blood lipid level, exerting a favorable safety.