补肾益气汤联合西药治疗Ⅳ期糖尿病肾病(气阴两虚)随机平行对照研究  

Randomized Controlled Study of Bushen Yiqi Decoction(补肾益气汤) combined with Western Medicine in the Treatment of Stage Ⅳ Diabetic Nephropathy(Qiyin Liangxu/气阴两虚)

作　　者：钟裕元[1] 李会珍[2] 张秋彬 ZHONG Yuyuan;LI Huizhen;ZHANG Qiubin(Baiyun District Hospital of Traditional Chinese Medicine：1. 1st Internal Medicine;2nd Internal Medicine,Guangzhou 510470,China)

机构地区：[1]广州市白云区中医医院内一科,广州510470 [2]广州市白云区中医医院内二科,广州510470

出　　处：《实用中医内科杂志》2018年第4期28-31,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察补肾益气汤联合西药治疗Ⅳ期糖尿病肾病(气阴两虚)疗效。[方法]使用随机平行对照方法,将72例住院及门诊患者按随机数字表方法随机分为两组。对照组35例,适当运动,控制饮食,蛋白摄入量<0.8/kg·d^(-1),根据临床症状、血糖、尿糖调整诺和灵30R,饭前30min注射,中型病例4~12U/次,重型病例12~24U/次;贝那普利,初始5mg/次,1次/d,根据病情可维持5mg^10mg/次,1次/d,对症治疗,纠正电解质紊乱、降压、利尿、抗凝等。治疗组37例补肾益元汤(黄芪30g,川芎、茯苓各20g,丹参、菟丝子、益智仁各15g,山药20g,山茱萸6g,补骨脂12g,赤芍15g,五昧子10g)水煎200mL,1剂/d,2次/d;其他干预同对照组。连续治疗30d为1疗程。观测临床症状、空腹血糖(FBG)、血尿素氮(BUN)、肌酐(Scr)、尿蛋白排泄率(UAER)、24h尿蛋白定量、不良反应。连续治疗2疗程(60d),判定疗效。[结果]治疗组显效13例,有效21例,无效3例,总有效率91.90%;对照组显效7例,有效15例,无效13例,总有效率62.86%;治疗组疗效优于对照组(P<0.05)。FBG、Scr、UAER、24h尿蛋白量两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]补肾益气汤联合西药治疗Ⅳ期糖尿病肾病(气阴两虚),疗效满意,无严重不良反应,值得推广。[Objective] To observe the curative effect of Bushen Yiqi decoction combined with western medicine in the treatment of diabetic nephropathy. [Methods] 72 hospitalized patients were randomly divided into two groups by random digital table method by random parallel control method. The control group of 35 cases, proper exercise, control diet, protein intake is less than 0.8/kg·d-1, according to the clinical symptoms, blood glucose, urine glucose adjusted Novolin 30R, before 30min injection, and 4 cases to 12 U/times, severe cases of 12～24U/time; benner pury, initial 5 mg/times, 1 times/d, according to the condition of 5mg can be maintained to 10 mg/times, 1 times/d. Symptomatic treatment, correction of electrolyte disorders, depressurization, diuresis, anticoagulant and so on. 37 cases in the treatment group were Bushen Yiyuan decoction： Huangqi 30g, Chuanxiong, Fuling each 20g, Danshen, Tusizi, Yizhiren each 15g, Shanyao 20g, Shanzhuyu 6g, Buguzhi 12g, Chishao 15g, Wuweizi 10g, decoction 200mL, 1 Ji/d, 2 times/d; other intervention with the control group. The continuous treatment of 30d was 1 courses. The clinical symptoms, fasting blood glucose （FBG）, blood urea nitrogen （BUN）, creatinine （Scr）, urinary protein excretion rate （UAER）, 24h urine protein quantitative and adverse reaction were observed. 2 courses of continuous treatment （60d） were used to determine the curative effect. [Results] The treatment group was markedly effective in 13 cases, effective in 21 cases, invalid in 3 cases, the total effective rate was 91.90%. In the control group, 7 cases were markedly effective, 15 cases were effective, 13 cases were invalid, the total effective rate was 62.86%, the treatment group was better than the control group （P〈0.05）. The urine protein of FBG, Scr, UAER and 24h were improved in two groups （P〈0.05）, and the improvement in the treatment group was better than that of the control group （P〈0.05）. [Conclusion] The effect of Bushen Yiqi decoction combined with western med

关 键 词：糖尿病肾病 气阴两虚 消渴 水肿 补肾益气汤 诺和灵 贝那普利 空腹血糖 血清尿素氮 肌酐 尿蛋白排泄率 24h尿蛋白定量 Mogensen分期 中药复方 随机平行对照研究 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]