健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期的疗效观察及对免疫功能的影响

The observation of the therapeutic effect and the influence on the immune function of the method of invigorating the spleen and tonifying the kidney,supplementing qi and removing turbidity in the treatment of diabetic nephropathy stage Ⅲ

关键词:  健脾补肾、益气祛浊法  缬沙坦  糖尿病肾病  肾小球  免疫功能

Key words:  methods of invigorating spleen and kidney,supplementing qi and removing turbidity  valsartan  diabetic nephropathy  glomerulus  immune function

摘要:

[目的] 观察健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期患者的临床疗效及对免疫功能的影响。[方法] 选择糖尿病肾病Ⅲ期患者，随机分为对照组和治疗组，两组均接受常规治疗及护理。对照组口服缬沙坦胶囊，80 mg/次，每日1次。治疗组在对照组的基础上加用中药汤剂口服。疗程8周，治疗前后进行疗效性观察指标、肾功能损害相关指标、免疫功能指标的检测。[结果] 治疗后治疗组中医症状评分、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、胆固醇（TC）、β2微球蛋白（β2-MG）、尿白蛋白排泄率（UAER）、血肌酐（SCr）、CD8⁺水平明显低于对照组；治疗组CD4⁺、CD4⁺/CD8⁺水平明显高于对照组，两组比较差异均有统计学意义（P<0.05）。治疗组临床疗效的总有效率为93.75%，明显高于对照组的62.50%，两组比较有统计学意义（P<0.05）。[结论] 健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期疗效显著，可有效降低患者β2-MG、UAER、SCr、BUN水平，改善糖尿病肾病Ⅲ期患者体内免疫功能，有效保护糖尿病肾病Ⅲ期患者的肾小球，延缓糖尿病肾病进展。

Abstract:

[Objective] To observe the clinical effect and immune function of invigorating the spleen and tonifying the kidney,supplementing qi and removing turbidity in the treatment of diabetic nephropathy stage Ⅲ.[Methods] Patients with diabetic nephropathy of stage Ⅲ were randomly divided into control group and observation group,both of which received routine treatment and nursing. The control group received valsartan capsule,80 mg,1/d. The observation group was added with Chinese herbal medicine decoction on the basis of the control group. The course of treatment was 8 weeks. Before and after the treatment,the therapeutic indexes,renal damage related indexes and immune function indexes were detected.[Results] After treatment,the symptom score,systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),total cholesterol (TC),β2-microglobulin (β2-mg),urinary albumin excretion rate (UAER),serum creatinine (SCr) and CD8⁺. level were significantly lower than control group. The levels of erum creatinine,SCr and CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05). The total effective rate of the observation group was 93.75%,which was significantly higher than that of the control group (62.50%) (P<0.05).[Conclusion] The method of invigorating the spleen and tonifying the kidney,supplementing qi and removing turbid can effectively reduce the level of β2-mg,UAER,SCr and BUN,improve the immune function of the patients with diabetic nephropathy,protect the glomerulus of the patients with diabetic nephropathy,and delay the progression of diabetic nephropathy.