世界中医药

目的：观察辛凉活血方对糖尿病肾病蛋白尿及血压、肾素影响。方法：选取2015—2017年西安交通大学附属西安市第九医院内分泌科符合糖尿病肾病Ⅳ期患者60例，随机分为观察组与对照组，每组30例，2组在入组前血糖无统计学意义的基础上，对照组给予同一ARB类降压药，观察组在此基础上加用辛凉活血方,治疗20 d后查尿蛋白定量及血压，并于治疗前后比较2组患者肾素、醛固酮水平。结果:治疗前2组患者尿蛋白定量差异无统计学意义，观察组较对照组，24 h尿蛋白定量减少更明显（P<0.05），差异有统计学意义；肾素：观察组较对照组治疗前差异无统计学意义，治疗后，观察组与对照组比较，差异有统计学意义（P<0.05）。观察组患者的临床疗效93.33%（28/30），高于对照组患者的46.67%（14/30），差异有统计学意义（P<0.05）。结论：活血化瘀药与辛凉药配伍（辛凉活血方）能明显降低糖尿病肾病尿蛋白及血压，这可能与该方明显降低患者血压有关，而血压的降低考虑与RAAS系统肾素、血管紧张素的变化有直接关系。

English Summary:

to observe the xinliang huoxue fang for the improvement of diabetic nephropathy proteinuria and blood pressure、reinin.Methods:Xi 'an hospital endocrinology Ⅳ stage of diabetic nephropathy patients with 60 cases were choosen with 30 cases of treatment group and control group.two groups in the group blood sugar before there was no significant difference on the basis of the control group given the same ARB kind of blood pressure medication,treatment group on the basis of the total xinliang huoxue fang,treatment in 20 days review quantitative urine protein and blood pressure.two groups of 24 hours urinary protein quantitative and blood pressure changes before and after the treatment were observed.Results:the treatment group than the control group 24 hours urinary protein quantitative there was no significant difference before treatment,the treatment group than the control group after treatment,24 hours urinary protein quantitative decreased significantly (P<0.05),statistically significant; Blood pressure:the treatment group than the control group systolic blood pressure,diastolic blood pressure,no significant difference before treatment,the treatment group than the control group after treatment,lower systolic and diastolic blood pressure have significant difference (P<0.05),statistically significant.The clinical efficacy of the observation group was 73.33% (22/30),which was higher than that of the control group (96.67%,29/30),the difference was statistically significant (P<0.05).Conclusion:the medicine for activating blood circulation and medicine of xing Liang compatibility (xinliang huoxue fang) can significantly reduce the urine protein of diabetic nephropathy,and this is obviously reduce blood pressure in patients with the party,and the blood pressure lowering consideration and RAAS renin,angiotensin system changes have a direct relationship,studies have shown that the treatment group renin made a big difference than the control group renin.

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