摘要
目的:基于双重差分法(DID)模型分析轻盈祛浊汤治疗痰湿瘀阻型糖尿病肾病(DN)的远期疗效及对血清25羟基维生素D[25(OH)D]水平的影响。方法:前瞻性选取2020年6月至2022年6月于该院就诊的痰湿瘀阻型DN患者120例,按照随机数字表法分为对照组和观察组,各60例。对照组患者接受常规西医标准化治疗,观察组患者在对照组的基础上予以轻盈祛浊汤治疗。比较两组患者的临床疗效,炎症因子、血钙、血磷和25(OH)D水平,采用DID模型对比两组患者治疗前后不同时间点(治疗前,治疗后1、2、3及6个月)的血清25(OH)D水平。结果:随访6个月,无1例失访。观察组患者的总有效率[93.33%(56/60)]较对照组[78.33%(47/60)]升高,差异有统计学意义(P<0.05)。观察组患者随访结束时肿瘤坏死因子α、白细胞介素(IL)6和IL-1β水平低于对照组,血钙水平高于对照组,血磷水平低于对照组,差异均有统计学意义(P<0.05)。血清25(OH)D水平在时间、组间、时间-组间交互项的差异均有统计学意义(P<0.05);DID回归模型显示,两组治疗前的差分效应量为0.844,且差异无统计学意义(P=0.329>0.1),满足平行趋势假设;两组治疗后的差分效应量为-1.878,且差异有统计学意义(P<0.05),即说明在治疗后各时间点,观察组的效应值明显高于对照组;双重差分效应值为-2.722,且差异有统计学意义(P=0.005)。结论:轻盈祛浊汤能上调痰湿瘀阻型DN患者维生素D水平,改善钙磷水平,减轻炎症水平,提高疗效。
OBJECTIVE:To analyze the long-term efficacy of Qingying Quzhuo decoction in the treatment of diabetic nephropathy(DN)of phlegm-dampness and blood stasis type based on Double difference model(DID)model and its effects on vitamin D level.METHODS:A total of 120 patients with DN of phlegm-dampness and blood stasis type admitted into the hospital from Jun.2020 to Jun.2022 were prospectively extracted to be divided into the control group and observation group via the random number table method,with 60 cases in each group.The control group received standard Western medicine treatment,while the observation group was given Qingying Quzhuo decoction on the basis of the control group.The clinical efficacy,inflammatory factor levels,calcium and phosphorus levels,and serum 25-hydroxyvitamin D[25(OH)D]levels were compared between two groups.DID model was used to compare the serum 25(OH)D levels of two groups before and after treatment at different time points(before treatment,after treatment of1,2,3 and 6 months).RESULTS:After 6 months of follow-up,no case was lost to follow-up.The total effective rate in the observation group(93.33%,56/60)was higher than that in the control group(78.33%,47/60),with statistically significant difference(P<0.05).At the end of follow-up,the levels of tumor necrosis factor(TNF)-α,interleukin(IL)-6 and IL-1βin the observation group were lower than those in the control group,the serum calcium level of the observation group was higher than that of the control group,and the serum phosphorus level was lower than that of the control group,with statistically significant differences(P<0.05).Serum 25(OH)D levels were all statistically significant(P<0.05).DID regression model showed that the difference effect size before treatment between two groups was 0.844,and the difference was not statistically significant(P=0.329>0.1),which met the parallel trend hypothesis.The difference effect size of two groups after treatment was-1.878,with statistically significant difference(P<0.05),indicating that the effect size of the observation group was significantly higher than that of the control group at different time point after treatment.The difference effect size was-2.722,and the difference was statistically significant(P=0.005).CONCLUSIONS:Qingying Quzhuo decoction can increase vitamin D level,improve calcium and phosphorus level,reduce inflammation level and improve curative effect in patients with DN of phlegm-dampness and blood stasis type.
作者
白海龙
边云
孟晓峰
王丽芳
王凤英
田风胜
崔荣岗
苏阳
李娟
BAI Hailong;BIAN Yun;MENG Xiaofeng;WANG Lifang;WANG Fengying;TIAN Fengsheng;CUI Ronggang;SU Yang;LI Juan(Dept.of Diabetes,Cangzhou Hospital of Integrated Traditional and Western Medicine,Hebei Cangzhou 061001,China;Prevention and Treatment Center,Cangzhou Hospital of Integrated Traditional and Western Medicine,Hebei Cangzhou 061001,China;Dept.of Laboratory,Cangzhou Hospital of Integrated Traditional and Western Medicine,Hebei Cangzhou 061001,China;Dept.of Imaging,Orthopedic Hospital,Cangzhou Hospital of Integrated Traditional and Western Medicine,Hebei Cangzhou 061001,China;Dept.of Nursing,Cangzhou Hospital of Integrated Traditional and Western Medicine,Hebei Cangzhou 061001,China)
出处
《中国医院用药评价与分析》
2024年第4期426-430,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省中医药管理局科研计划项目(No.2020465)。
关键词
轻盈祛浊汤
糖尿病肾病
痰湿瘀阻型
维生素D
双重差分法模型
Qingying Quzhuo decoction
Diabetic nephropathy
Phlegm-dampness and blood stasis type
Vitamin D
Double difference model
