内科

目的观察加味升降散治疗糖尿病肾病患者的临床疗效。方法选择2019年1月至2021年1月河南中医药大学第一附属医院收治的糖尿病肾病患者80例为研究对象，采用随机数字法分为对照组和观察组，每组40例。对照组患者给予常规治疗，观察组患者在对照组治疗的基础上联合加味升降散治疗，疗程4周，疗程结束后随访患者6个月。比较两组患者的临床疗效；比较两组患者治疗前后的肾功能以及肾血流指标、氧化应激指标水平。结果治疗4周后以及随访6个月时，观察组患者的治疗总有效率均明显高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的24h尿蛋白定量、尿白蛋白排泄率、血尿素氮水平比较，差异无统计学意义(P＞0.05)；治疗4周后，两组患者的24h尿蛋白定量、尿白蛋白排泄率、血尿素氮水平均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义(P＜0.05)。治疗前，两组患者肾动脉的阻力指数（RI）、收缩期峰值流速（PSV）、舒张末期的血流速度（EDV）比较，差异无统计学意义(P＞0.05) 。治疗4周后，两组患者肾动脉的RI水平均显著降低，PSV、EDV水平均显著升高；观察组患者RI水平显著低于对照组；PSV、EDV水平显著高于对照组，差异有统计学意义(P＜0.05) 。治疗前，两组患者的超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、晚期蛋白氧化产物（AOPPs）水平比较，差异无统计学意义(P＞0.05)。治疗4周后，两组患者的SOD、GSH-Px水平均明显升高，AOPPs水平均明显降低；观察组患者的SOD、GSH-Px水平显著高于对照组，AOPPs水平显著低于对照组，差异有统计学意义(P＜0.05) 。结论在常规治疗的基础上，联合加味升降散治疗可更明显地改善糖尿病肾病患者的临床症状、肾功能、肾血流状况及氧化应激指标水平。

ObjectiveTo observe the clinical efficacy of modified shengjiang powder on diabetic nephropathy. MethodsA total of 80 cases with diabetic nephropathy admitted to the first affiliated hospital of Henan university of CM from January 2019 to January 2021 were selected as the research objects, and they were divided into control group and observation group by the random number method, with 40 cases in each group. The control group was given conventional treatment, while the observation group was treated with modified shengjiang powder based on the control group, for a 4-week treatment course. And the patients were followed up for 6 months after the end of the treatment course. Clinical efficacy of the two groups was compared. The renal function, levels of renal blood flow index and oxidative stress index were compared between the two groups before and after treatment. ResultsAfter 4 weeks of treatment and 6 months of follow-up, the total effective rate of treatment of the observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in the 24-hour urine protein, urinary albumin excretion rate and blood urea nitrogen level between the two groups (P＞0.05). After 4 weeks of treatment, 24-hour urine protein, urinary albumin excretion rate and blood urea nitrogen level significantly decreased in both groups, and the levels of the observation group were significantly lower than those of the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in renal artery resistive index (RI), peak systolic velocity (PSV) and end diastolic blood flow velocity (EDV) between the two groups (P＞0.05). After 4 weeks of treatment, the levels of renal artery RI in the two groups decreased significantly, while the levels of PSV and EDV of renal artery increased significantly. Patients in the observation group reached significantly lower level of RI and higher levels of PSV and EDV than those of the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), advanced oxidation protein products (AOPPs) between the two groups (P＞0.05). After 4 weeks of treatment, the levels of SOD, GSH-Px in the two groups increased significantly, while the levels of AOPPs decreased significantly. Patients in the observation group had higher levels of SOD and GSH-Px, and lower level of AOPPs than those in the control group, with statistically significant differences (P＜0.05). ConclusionOn the basis of conventional treatment, combination with modified shengjiang powder treatment resulted in more obvious improvements in clinical symptoms, renal function, renal blood flow status, and oxidative stress index levels in patients with diabetic nephropathy.