研究疾病:
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糖尿病肾病
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研究疾病代码:
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Target disease:
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Diabetic Kidney Diease
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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上市后药物
Post-marketing clinical trial
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研究目的:
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糖尿病肾病(Diabetic Nephropathy,DN)是糖尿病主要微血管并发症之一,主要表现为肾小球血管受损、硬化形成结节性病变,进而引起肾功能的异常和持续性的尿蛋白,是目前导致终末期肾病最主要的病因,也是造成糖尿病患者高死亡率的原因之一[1]。2型糖尿病患者中糖尿病肾病发病率高达 30%-50%?糖尿病肾病已经成为我国慢性肾脏病的主要原因,给患者带来巨大的经济负担,糖尿病肾病进展快,疗效差,其治疗方案的探究一直是肾脏领域的一大难题。糖尿病肾病属于中医学“水肿” “消渴” “关格”等范畴,是由于多种因素引起人体气化功能失常,水谷精微不能正常蒸化输布,从而影响肺、脾、肾等生理功能,属本虚标实之证,气阴两虚为其本,淤血阻络为其标。气阴两虚、血瘀阻络贯穿糖尿病肾病病程始终,在糖尿病肾病并发症发生发展中具有重要地位,故益气养阴、活血化瘀是治疗的重要靶点。因此,在西医治疗方案有限的情况下,如何使用中医药有效的防治慢性肾脏病患者的肾功能衰竭,延缓糖尿病肾病的进展,以及对其确切机制的深入探究是目前国内外肾脏领域研究的重点,具有重要的临床价值和社会意义。
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Objectives of Study:
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Diabetic Nephropathy (Diabetic Nephropathy, DN) is one of the main microvascular complications of diabetes, mainly manifested as glomerular vascular damage, hardening to form nodular lesions, which in turn causes abnormal renal function and persistent urine protein, which is currently caused The most important cause of end-stage renal disease is also one of the causes of high mortality in diabetic patients [1]. The incidence of diabetic nephropathy in type 2 diabetic patients is as high as 30%-50%. Diabetic nephropathy has become the main cause of chronic kidney disease in my country, bringing a huge economic burden to patients. Diabetic nephropathy progresses quickly and has poor curative effects. Explore its treatment options It has always been a big problem in the kidney field. Diabetic nephropathy belongs to the categories of "edema", "diarrhea", and "Guange" in traditional Chinese medicine. It is caused by a variety of factors that cause the human body to malfunction. The essence of water can not be vaporized and transferred, which affects the physiological functions of the lungs, spleen, and kidneys. , It is the syndrome of the deficiency of the essence, the deficiency of both qi and yin is the essence, and the obstruction of blood congestion is the criterion. Deficiency of both qi and yin and blood stasis block the collaterals throughout the course of diabetic nephropathy and play an important role in the occurrence and development of complications of diabetic nephropathy. Therefore, replenishing qi and nourishing yin, promoting blood circulation and removing blood stasis are important targets for treatment. Therefore, in the case of limited Western medicine treatment options, how to use Chinese medicine to effectively prevent renal failure in patients with chronic kidney disease, delay the progression of diabetic nephropathy, and in-depth exploration of its exact mechanism is the focus of research in the field of kidney at home and abroad. , Has important clinical value and social significance.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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1.符合西医 2 型糖尿病、糖尿病肾病诊断标准;
2.24h 尿蛋白定量≥0.5g/24h 且≤3.0g/24h;
3.eGFR为15ml/min/1.73m2~59ml/min/1.73m2(CKD-EPI 公式计算);
4.空腹血糖<13.9mmol/L 和(或)餐后 2 小时血糖<16.6mmol/L;
5.HbA1c≤10%;
6.年龄≥35 岁且≤75 岁,性别不限;
7.自愿签署知情同意书。
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Inclusion criteria
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1.Meet the diagnostic criteria of type 2 diabetes and diabetic nephropathy in western medicine;
2.24h urine protein quantitative 0.5g/24h to 3.0g/24h;
3.eGFR is 15ml/min/1.73m2~59ml/min/1.73m2 (calculated by CKD-EPI formula);
4.Fasting blood glucose <13.9mmol/L and/or 2 hours postprandial blood glucose <16.6mmol/L;
5.HbA1c<=10%;
6.Aged 35 to 75 years;
7.Sign the informed consent form voluntarily.
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排除标准:
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1.单纯肾源性血尿或蛋白尿伴血尿,或肾功能正常但突然出现水肿和大量蛋白尿,显著肾小管功能减退,合并明显的异常肾小管型,有原发性肾小球肾炎或除糖尿病肾病之外的继发性肾炎,泌尿系统急、慢性感染;
2.三个月内发生过严重心血管疾病:有心梗病史,或进行过冠脉搭桥或PCI 手术的缺血性心脏病、充血性心衰(心功能Ⅲ-Ⅳ级,NYHA 评级)患者,或有严重脑血管疾病患者(卒中及卒中后遗留明显神经系统功能障碍);
3.合并肝、造血系统、内分泌系统、呼吸系统等其他严重全身性原发性疾病及功能障碍患者;ALT、AST>正常值上限2.5 倍者;
4.慢性腹泻者,定义为排便次数增多(>3 次/日),粪便量增加,粪质稀薄,腹泻超过 3~6 周或反复发作;
5.三个月内曾发生活动性出血者;
6.凝血功能异常者;
7.有酗酒、滥用药物或精神疾病史者;
8.处于妊娠期、哺乳期或计划在研究期间妊娠的女性;
9.近3 个月内参加过其他临床试验者;
10.研究者认为其他不适宜参加本临床试验者。
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Exclusion criteria:
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1. Simple nephrogenic hematuria or proteinuria with hematuria, or normal renal function but sudden edema and massive proteinuria, significant renal tubular dysfunction, combined with obvious abnormal tubular type, primary glomerulonephritis or Secondary nephritis except diabetic nephropathy, acute and chronic urinary system infection;
2. Severe cardiovascular disease occurred within three months: a history of myocardial infarction, or ischemic heart disease and congestive heart failure that have undergone coronary bypass or PCI surgery (heart function grade III-IV, NYHA rating) Patients, or patients with severe cerebrovascular disease (stroke and significant neurological dysfunction remaining after stroke);
3. Combined with liver, hematopoietic system, endocrine system, respiratory system and other serious systemic primary diseases and dysfunctions
Patients: ALT, AST>2.5 times the upper limit of normal;
4. Chronic diarrhea is defined as increased frequency of bowel movements (>3 times/day), increased stool volume, thin stools, diarrhea for more than 3 to 6 weeks or recurrent episodes;
5. Those who have had active bleeding within three months;
6. Abnormal blood coagulation function;
7. People with a history of alcohol abuse, drug abuse or mental illness;
8. Women who are pregnant, breastfeeding or planning to become pregnant during the study period;
9. Those who have participated in other clinical trials within the past 3 months;
10. The investigator believes that others are not suitable to participate in this clinical trial.
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研究实施时间:
Study execute time:
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从From
2021-09-01
至To
2023-06-30
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征募观察对象时间:
Recruiting time:
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从From
2022-02-01
至To
2022-12-31
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