南征教授应用加味消肾安汤治疗糖尿病肾病Ⅳ期的临床观察  

Clinical observation on professor Nanzheng ’s application of Jiawei Xiaoshen’an Decoction in treating stage Ⅳ of diabetic nephropathy

作　　者：张静静 刘乐 张琦[1] 王新娜[1] 南征(指导) 

机构地区：[1]长春中医药大学,吉林130117 [2]长春中医药大学附属医院

出　　处：《现代中医临床》2019年第6期7-11,共5页Modern Chinese Clinical Medicine

基　　金：国家重点研发计划项目资助(No.2018YFC1704100),国家重点研发计划项目资助课题(No.2018YFC1704102)

摘　　要：目的观察南征教授应用加味消肾安汤治疗糖尿病肾病IV期的临床疗效。方法将120例糖尿病肾病IV期患者随机分为治疗组60例、对照组60例。剔除脱落病例后治疗组为57例、对照组为56例。治疗组在常规治疗基础上予加味消肾安汤加减治疗。对照组在常规治疗基础上予缬沙坦肢囊治疗。观察2组临床疗效,中医症状积分,24 h尿蛋白定量、糖化血红蛋白(HbAlc)及空腹血糖(FBG),安全指标。结果2组临床疗效比较,治疗组57例中,显效15例,有效31例,无效11例,总有效46例,总有效率为80.70%;对照组56例中,显效9例,有效27例,无效20例,总有效36例,总有效率为64.29%。经秩和检验,Z=-2.043,P二0.041,尸<0.05,说明治疗组疗效优于对照组。治疗后治疗组倦怠乏力、腰膝酸软、头晕耳鸣、纳差、水肿、尿浊、尿频积分较本组治疗前均降低(P<0.05)。对照组倦怠乏力、腰膝酸软、水肿、尿浊症状积分较本组治疗前均降低(P<〇.〇5)。治疗组倦怠乏力、腰膝酸软、水肿、尿浊积分较对照组降低明显,治疗前后积分差值比较,差异有统计学意义(P<〇.〇5)。治疗后治疗组24 h尿蛋白定量,HbAlc,FBG水平较本组治疗前均下降(P<0.05)。对照组24 h尿蛋白定量,FBG水平较本组治疗前均下降(P<0.05)。治疗组24 h尿蛋白定量,HbAlc,FBG较对照组下降明显,治疗前后差值比较,差异均有统计学意义(P<〇.〇5),治疗组优于照组。结论加味消肾安汤治疗糖尿病肾病IV期具有较好的临床疗效。Objective To observe the clinical effect of professor Nan Zheng * s application of JiaweiXiaoshen * an Decoction in the treatment of stage IV of diabetic nephropathy. Methods 120 patientswith stage IV of diabetic nephropathy were randomly divided into treatment group and control group, with60 cases in each group. There were 57 cases in the treatment group and 56 cases in the control group afterremoving the shedding cases. The treatment group was treated with Jiawei Xiaoshen ’ an Decoction on thebasis of conventional treatment. The control group was treated with valsartan capsule on the basis ofconventional treatment. The clinical efficacy, TCM symptom score, 24 h urine protein quantitation,HbAlc and FBG and safety indicators were observed. Results The clinical efficacy of the two groupswas compared. Among the 57 cases in the treatment group, 15 cases showed markedly effective, 31 caseswere effective, 11 cases were ineffective, the total effective cases were 46 and the total effective rate was80. 7 0 % . Among the 56 cases in the control group, 9 cases showed markedly effective, 27 cases wereeffective, 20 cases were ineffective, the total effective cases were 36 and the total effective rate was 64. 29% . Rank sum test analysis showed Z = - 2 . 043 , P =0. 041 , P <0. 05 , which indicated the totalefficacy rate of treatment group was superior to control group. After treatment, in the treatment group, thescores of fatigue, weakness of the waist, dizziness and tinnitus, anorexia, edema, turbidity and urinaryfrequency were decreased than those before treatment ( P < 0 . 0 5 ) . In the control group, the scores offatigue, weakness of the waist, edem a, and turbidity were decreased than those before treatment( P <0 .0 5 ). The scores of fatigue, weakness of the waist, edema, and turbidity in the treatment group weredecreased than control group. The difference of the score before and after treatment was statisticallysignificant ( P < 0 . 05 ). After treatment, in the treatment group, the 24 h urine protein quantitation

关 键 词：加味消肾安汤 益肾解毒通络法 糖尿病肾病IV期 南征 

分 类 号：R255.4[医药卫生—中医内科学]