健脾利湿汤治疗儿童糖尿病合并急性肾衰竭的疗效与安全性评价

doi:10.3969/j.issn.1674-3865.2020.05.023

摘要/Abstract

摘要： 目的探讨儿童糖尿病合并急性肾衰竭患儿健脾利湿汤治疗的临床效果及安全性。〖方法以2016年2月至2019年3月本院收治的儿童糖尿病合并急性肾衰竭患儿100例为研究对象，随机分为对照组和观察组各50例。对照组给予口服降糖或皮下注射胰岛素、服用厄贝沙坦、血管紧张素转换酶抑制剂治疗，观察组在对照组治疗基础上给予健脾利湿汤治疗，均治疗8周比较患儿临床效果，评估中医症状积分，比较空腹血糖、餐后2 h血糖及糖化血红蛋白水平、肾功能指标，观察用药安全性。结果观察组患儿总有效率为94.0%（47/50），显著高于对照组78.0%（39/50），差异有统计学意义（P<0.05）。治疗4周、8周后两组中医症状积分均显著降低，观察组低于对照组，差异有统计学意义（P<0.05）；治疗4周和8周后两组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均显著降低，观察组均低于对照组，差异有统计学意义（P<0.05）；治疗4周、8周后两组血肌酐、血尿素氮水平均降低，观察组显著低于对照组，两组肾小球滤过率水平升高，观察组显著高于对照组，差异有统计学意义（P<0.05）；两组均未见明显药物不良反应。结论健脾利湿汤联合西药治疗儿童糖尿病合并急性肾衰竭的疗效更加显著，血糖控制更加理想，改善患儿中医临床症状，保护患儿肾功能，安全可靠，值得推广。

关键词: 糖尿病, 急性肾衰竭, 健脾利湿汤, 儿童

Abstract: Objective To investigate the clinical effect and safety of Jianpi Lishi decoction in children with diabetes and acute renal failure. Methods A total of 100 children with diabetes mellitus and acute renal failure admitted to our hospital from February 2016 to March 2019 were randomly divided into 2 groups: 50 cases in the control group and 50 in observation group. Both groups were given oral hypoglycemic or subcutaneous injection of insulin, irbesartan, and angiotensinconverting enzyme inhibitors for treatment, and the observation group was additionally given Jianpi Lishi decoction, both being treated for 8 weeks. The clinical effects, TCM symptom scores, the fasting plasma glucose(FPG), 2h plasma glucose(2hPG) and glycated hemoglobin(HbAlc) levels, and renal function indexes were compared, and the safety of medication was observed. Results The total effective rate of the observation group was 94.00%（47/50）, which was significantly higher than that of the control group（78.00%，39/50）, the difference being statistically significant(P＜0.05).After 4 weeks and 8 weeks of treatment, the TCM symptom scores of the observation group and the control group were significantly reduced, and the observation group was lower than the control group, the difference being statistically significant(P＜0.05); after 4 weeks and 8 weeks of treatment, the levels of FPG, 2hPG and HbAlc in the two groups were significantly reduced, and the observation group was lower than the control group, and the difference was statistically significant(P＜0.05). At the 4th and 8th week of treatment, the Cr and BUN levels of the two groups decreased significantly, and the observation group was significantly lower than the control group; the GFR level of the two groups increased, and the observation group was significantly higher than the control group, the difference being statistically significant(P＜0.05). No obvious adverse drug reactions were seen in both groups. Conclusion Jianpi Lishi decoction combined with western medicine is more effective in treating children with diabetes and acute renal failure, and blood sugar control better, which can improve the clinical symptoms of traditional Chinese medicine in children and protect the kidney function of children. It is safe and reliable, and worthy of promotion.

Key words: Diabetes, Acute renal failure, Jianpi Lishishui decoction, Children

李博. 健脾利湿汤治疗儿童糖尿病合并急性肾衰竭的疗效与安全性评价[J]. 中国中西医结合儿科学, 2020, 12(5): 450-453.

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健脾利湿汤治疗儿童糖尿病合并急性肾衰竭的疗效与安全性评价

Evaluation of efficacy and safety of Jianpi Lishi decoction in treating children with diabetes complicated with acute renal failure

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