益气养阴、活血化瘀散结法治疗2型糖尿病肾病Ⅲ、Ⅳ期气阴两虚夹瘀型40例临床研究  

Clinical Study on Supplementing qi and Nourishing yin,Promoting Blood Circulation and Removing Blood Stasis to Treat 40 Cases of Type 2 Diabetic Nephropathy( Ⅲ ～ Ⅳ) in Deficiency of qi and yin Combined with Blood Stasis Patients

作　　者：高菁[1] 李靖[1] 莫士安[1] 庄杰[1] 来于[1] 

机构地区：[1]北京中医药大学东直门医院肾病科,北京100700

出　　处：《世界中医药》2013年第5期530-534,共5页World Chinese Medicine

基　　金：北京市首都发展基金联合攻关课题"中医药治疗糖尿病肾病临床疗效评价方法的研究(编号:2005-SF-I-015)"的资助

摘　　要：目的:观察益气养阴、活血化瘀散结法治疗2型糖尿病肾病的临床疗效。方法:将40例糖尿病肾病患者随机分成治疗组和对照组,以安慰剂为对照,治疗组和安慰剂组的比例约为2∶1。治疗组以益气养阴、活血化瘀散结为主法,以黄芪、生地黄、制大黄、夏枯草、三七、卫矛、山茱萸、枳壳组方(以下称治疗方)治疗12周。观察治疗前后中医证候积分、尿微量白蛋白、24h尿蛋白定量、糖化血红蛋白、肝肾功能、血脂等指标。结果:治疗组中医证侯积分与服药前相比有所降低,服药时间越长降低越明显,服药8周后显示出统计学差异,服药12周总有效率达81.48%;治疗组患者尿蛋白较治疗前有所下降,与治疗前及与安慰剂组相比较均具有统计学差异。结论:益气养阴、活血化瘀散结法能够有效改善糖尿病肾病Ⅲ、Ⅳ期气阴两虚夹瘀型患者的临床症状,可以控制早期糖尿病肾病的进展,是中医药干预治疗早期糖尿病肾病可以选择的有效治疗方案。Objective：To evaluate the effectiveness of supplementing qi and nourishing yin, promoting blood circulation and removing blood stasis therapy in treating type 2 diabetic nephropathy. Methods.Forty patients of diabetic nephropathy were randomly divided into treatment group and control group in a proportion of 2 ： 1. The treatment group applied supplementing qi and nourishing yin promoting blood circulation and removing blood stasis therapy, using the treatment formula including herbs of astragalus mongholicus, rehmanniae radix, prepared rhubarb, selfheal, panax pseudoginseng, winged euonymus, comus, fructus Aurantii. Placebo was used in the control group. The treatment lasted for 12 weeks. The indexes of TCM syndrome score, MAU, 24 h urine protein quantitative, glycosylated he- moglobin, hepatic and renal functions, and blood-lipid before and after treatment were observed and analyzed. Results：The TCM syn- drome score decreased in treatment group after taking medicine with a decline by weeks. Statistical difference was found after 8 weeks, and the total effective rate was 81.48% at the end of 12 weeks. Compared with pre-treatment and placebo group, urinary protein also decreased after treatment with a significant difference. Conclusion： The therapy of supplementing qi and nourishing yin, promoting blood circulation and removing blood stasis could improve the symptoms of patients with diabetic nephropathy （Ⅲ-Ⅳ） in deficiency of qi and yin combined with blood stasis, and prevent the aggravation of diabetic nephropathy in Ⅲ,Ⅳ period. It could be recommended for TCM clinical use in treating EDN.

关 键 词：糖尿病肾病 中医药疗法 气阴两虚夹瘀 益气养阴活血 化瘀散结 

分 类 号：R587.2[医药卫生—内分泌]