叶氏软坚泄浊方治疗痰瘀阻滞型糖尿病肾病Ⅳ期临床研究  

Clinical Study on the Treatment of Phlegm and Blood Stasis Type Phase Ⅳ Diabetic Nephropathy with Ye's Ruanjian Xiezhuo Recipe

作　　者：蔡艳[1] 马子杰[1] 张晓丹[1] 王归雁 杨慰[1] 朱雪萍[1] CAI Yan;MA Zijie;ZHANG Xiaodan(The 7th People＇s Hospital Attached to Shanghai University of Traditional Chinese Medicine （ Shanghai 200137, China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《四川中医》2018年第5期114-117,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市浦东新区名中医继承人培养建设项目(编号:PDZYXK-6-2014025)

摘　　要：目的:观察叶氏软坚泄浊方结合西医常规疗法治疗痰瘀阻滞型糖尿病肾病Ⅳ期的临床疗效及其安全性。方法:将65例痰瘀阻滞型糖尿病肾病Ⅳ期患者随机分为治疗组(34)和对照组(31)。对照组:在西医常规治疗的基础上加用氯沙坦钾片100mg,每日1次口服;治疗组:在对照组的基础上口服叶氏软坚泄浊方,以1个月为1个疗程,连续治疗3个疗程后,比较治疗前后的临床疗效及安全性。结果:叶氏软坚泄浊方组的中医疗效总有效率为85.3%,氯沙坦钾片组总有效率为54.8%,两组相比较,差异有统计学意义(P<0.05);治疗后叶氏软坚泄浊方组的ACR、24小时尿蛋白定量、肌酐、肾小球滤过率、白蛋白、血糖、糖化血红蛋白与对照组相比,差异有统计学意义(P<0.05);治疗后叶氏软坚泄浊方治疗组的中医证候评分与对照组相比,差异有统计学意义(P<0.05);两组患者在用药过程当中,各项安全性指标,包括肝功能(谷丙、谷草)、心电图以及血常规等都没有出现明显异常。结论:叶氏软坚泄浊方治疗能有效减轻痰瘀阻滞型糖尿病肾病Ⅳ期患者的临床症状,推迟Ⅳ期糖尿病肾病进入终末期肾病(ESRD)的进程,无明显毒副反应,安全性高。Objective： To observe the clinical efficacy of using Ye＇s Ruanjian Xiezhuo Recipe combined with western routine therapy in the treatment of phlegm and blood stasis type phase IVdiabetic nephropathy（ DN） and its security. Methods： 65 cases of patients with phlegm and blood stasis diabetic nephropathy phase IV were randomly divided into treatment group（ 34） and controlled group（ 31）. The controlled group（ 31） ： on the basis of routine treatment of western medicine with Losartan Potassium Tablet 100 mg,once a day; The treatment group（ 34） ： Giving Ye＇s Ruanjian Xiezhuo Recipe on the basis of the controlled group,a month for a course of treatment,continuous clinical efficacy and safety of treatment before and after comparison of three courses. Results： The total effective rate of Ye＇s Ruanjian Xiezhuo group of Chinese medicine was 85. 3% and the total effective rate of Losartan Potassium Tablet group of Chinese medicine was 54. 8%. The total effective rate of the two groups was compared,the difference was statistically significant（ P〈0. 05）. After treatment,Ye＇s Ruanjian Xiezhuo group of ACR,24 h urine protein,serum creatinine,glomerular filtration rate（ e GFR）,albumin,blood glucose,glycosylated hemoglobin glycosylated hemoglobin compared with the controlled group,the difference was statistically significant（ P〈0. 05）. After treatment,the syndromes score of Ye＇s Ruanjian Xiezhuo group compared with the controlled group,the difference was statistically significant（ P〈0. 05）. During the treatment the blood liver function（ ALT,AST）,electrocardiogram of the two group patients had no obvious abnormalities.Conclusion： Treatment of Ye＇s Ruanjian Xiezhuo Recipe can effectively alleviate the symptoms of chronic with phlegm and blood stasis of diabetic nephropathy phase IV,delayed stage diabetic nephropathy（ DN） of IV phase into end-stage renal disease（ ESRD） process,no significant side effects,and safe.

关 键 词：叶氏软坚泄浊方 糖尿病肾病Ⅳ期 痰瘀阻滞型 临床疗效 

分 类 号：R587.2[医药卫生—内分泌]