Efficacy of Liuwei Dihuang Pill on the Chronic Kidney Disease Induced by Dibetes Mellitus and Hypertensive Diseases_West China Medical Journal

Authors：

ZHENG Xiaomei ¹ , DAI Hongxun ¹ , HUANG Zongwen ² , LIN Huozhen ¹ , ZHANG Shaoying ¹ , ZHANG Qing ¹

1. Department of Internal Medicine, the Fifth Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China; 2. Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

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Keywords：

六味地黄丸; 糖尿病; 高血压病; 慢性肾脏疾病; 胰岛素抵抗

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【摘要】　目的　探讨六味地黄丸对糖尿病合并高血压病所致慢性肾脏疾病（chronic kidney disease，CKD）患者肾损害及胰岛素抵抗的影响。　方法　收集2008年7月1日-2010年7月1日在成都市第五人民医院住院部及门诊就诊的120例糖尿病合并高血压病患者相关资料，随机分为对照组和治疗组各60例，对照组给予西医治疗，治疗组在西医治疗的基础上加用六味地黄丸，12周为1个疗程。观察治疗前后尿白蛋白∕尿肌酐（ACR），内生肌酐清除率（Ccr）及胰岛素抵抗指数（HOMA-IR）、C反应蛋白（CRP）、血脂等指标的变化。　结果　治疗后治疗组与对照组比较，ACR（P=0.012）、血清CRP（P=0.000）和低密度脂蛋白（P=0.014）差异有统计学意义。HOMA-IR治疗前后结果差异有统计学意义（Plt;0.05），但与对照组比较差异无统计学意义（Pgt;0.05）。　结论　六味地黄丸可改善肾损害实验室指标，改善胰岛素抵抗，减轻体内炎性反应，改善脂代谢异常。
【Abstract】　Objective　To investigate the efficacy of Liuwei Dihuang pill on patients with chronic kidney disease (CKD) induced by diabetes mellitus and hypertensive diseases in terms of renal injury and insulin resistance. 　Methods　We collected the clinical data of 120 patients with diabetes mellitus and hypertensive diseases in the Fifth People’s Hospital of Chengdu from July 1, 2008 to July 1, 2010, and randomly divided them into two groups. In the control group, patients only received therapy of western medicine, while for patients in the treatment group, Liuwei Dihuang pills were added on the basis of western medicine treatment with a treatment course of 12 weeks. Before and after the treatment, urinary albumin / urinary creatinine (ACR), creatinine clearance rate (Ccr) and insulin resistance index (HOMA-IR), C-reactive protein (CRP), and lipids were evaluated and compared.　Results　After treatment, ACR (P=0.012), serum CRP (P=0.000) and low-density lipoproteins (LDL) (P=0.014) for the treatment group were significantly different from those for the control group. HOMA-IR for the treatment group before and after the treatment was significantly different (Plt;0.05), while there was no statistical difference between the two groups in HOMA-IR (Pgt;0.05).　Conclusion　Kidney-nourishing therapy with Liuwei Dihuang pill can improve the laboratory indicators of renal injury or insulin resistance, reduce the inflammatory response in vivo, and ameliorate disorders of lipid metabolism.

Citation： ZHENG Xiaomei,DAI Hongxun,HUANG Zongwen,LIN Huozhen,ZHANG Shaoying,ZHANG Qing. Efficacy of Liuwei Dihuang Pill on the Chronic Kidney Disease Induced by Dibetes Mellitus and Hypertensive Diseases. West China Medical Journal, 2011, 26(4): 490-492. doi: Copy

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1. 　中国高血压防治指南修订委员会. 2004年中国高血压防治指南(实用本)[J]. 中华心血管病杂志, 2004, 32(12): 1060-1064.
2. 　钱荣立. 糖尿病临床指南[M]. 北京: 北京医科大学出版社, 2002: 214-218.
3. 　Eckardt KU, Berns JS, Rocco MV, et al. Definition and classification of CKD: the debate should be about patient prognosis-a position statement from KDOQI and KDIGO[J]. Am J Kidney Dis, 2009, 53(6): 915-920.
4. 　郑筱萸. 中药新药临床研究指导原则[M]. 北京: 中国医药科技出版社, 2002: 163.
5. 　王海鹰, 蔡蓉, 刘文斌, 等. 影响2型糖尿病患者尿白蛋白/肌酐值的相关因素分析[J]. 中华全科医师杂志, 2005, 4(1): 20-22.
6. 　高妍. 糖尿病与高血压治疗进展[J]. 中华内科杂志, 1999, 38(10): 714-716.
7. 　羽田胜计. 糖尿病肾病[J]. 最新医学, 2000, 55(3): 362-367.
8. 　朱小娟, 金惠敏. 慢性肾脏疾病与胰岛素抵抗的研究进展[J]. 中国血液净化, 2009, 8(4): 219-221.
9. 　Hoehner CM, Green Lund KJ, Rith-Najarian S, et al. Association of the insulin resistance syndrome and microalbu-minuria among nondiabetic native Americans. The Inter Tribal Heart Project[J]. J Am Soc Nephrol, 2002, 13(6): 1626-1634.
10. 　周国英, 武雪萍, 衡先培, 等, 2型糖尿病中医辨证分型与胰岛素抵抗的关系[J]. 福建中医学院学报, 2002, 212(4): 3-5.
11. 　郭石宏, 侯国华. 慢性肾功能衰竭的分期论治[J]. 山西中医, 2006, 22(1): 60-61.
12. 　Levey AS, Eckardt KU, Tsukamoto Y, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)[J]. Kidney Int, 2005(67): 2089-2100.
13. 　孙云霞. 试论中医治未病思想在预防胰岛素抵抗综合征中的作用[J]. 甘肃中医, 2006, 19(10): 5-6.
14. 　江南, 刘铜华. 胰岛素抵抗的中医病机探讨[J]. 中国中医基础医学杂志, 2006, 12(9): 690-692.
15. 　孙卫卫, 刘忠杰, 张恩, 等. 慢性肾脏疾病3, 4, 5期中医证候学的临床研究[J]. 北京中医药大学学报(中医临床版), 2009, 16(5): 14-16.

West China Medical Journal

Efficacy of Liuwei Dihuang Pill on the Chronic Kidney Disease Induced by Dibetes Mellitus and Hypertensive Diseases

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