温阳消癥法治疗糖尿病肾病Ⅳ期患者疗效观察  

Clinical efficacy of therapy for Warming Yang and resolving mass in patients with stage Ⅳ diabetic nephropathy

作　　者：闫润泽 孙卫卫[1] 王艺 王晓娜[1] 杨涵雯[1] YAN Runze;SUN Weiwei;WANG Yi;WANG Xiaona;YANG Hanwen(Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine,Beijing 100007)

机构地区：[1]北京中医药大学东直门医院,北京100007

出　　处：《现代中西医结合杂志》2020年第29期3193-3197,3286,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：北京中医药大学青年教师项目(2017-JYB-JS-075)。

摘　　要：目的探讨温阳消癥法治疗糖尿病肾病Ⅳ期患者的临床疗效。方法选取2016年10月—2017年6月北京中医药大学东直门医院诊治且符合纳入标准的糖尿病肾病Ⅳ期患者66例,按照随机抽样法分成观察组32例和对照组34例。对照组予西医常规基础治疗,观察组予西医常规基础治疗联合温阳消癥法(以真武汤加用活血消癥类中药为基础)治疗,2组治疗时间均为6个月。观察2组治疗前后中医证候积分、肾功能[24 h尿蛋白定量、血肌酐(SCr)、血尿素氮(BUN)、肾小球滤过率(eGFR)、血尿酸(UA)]、血压[收缩压(SBP)、舒张压(DBP)]、血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]及血脂[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、血清白蛋白(ALB)、血红蛋白(Hb)水平变化,统计2组疾病疗效、中医证候疗效和不良反应发生情况。结果与治疗前比较,观察组治疗后中医证候积分、24 h尿蛋白定量明显降低(P均<0.05),血清ALB水平明显升高(P<0.05),其余指标变化不明显(P均>0.05);对照组各指标变化均不明显(P均>0.05)。与对照组比较,观察组治疗后中医证候积分、24 h尿蛋白定量、SCr水平更低(P均<0.05),血清ALB水平更高(P<0.05)。观察组疾病疗效总有效率为53.1%(17/32),中医证候疗效总有效率为65.6%(21/32),对照组分别为35.3%(12/34)和41.2%(14/34),2组比较差异均有统计学意义(P均<0.05)。2组均无明显不良反应发生。结论温阳消癥法治疗糖尿病肾病Ⅳ期患者能够明显改善临床症状,减少蛋白尿,保护肾功能,升高血清ALB,缓解病情进展效果明显优于单纯西医常规治疗。Objective It is to explore the clinical efficacy of the therapy for warming Yang and resolving mass in the treatment of patients with stage IV diabetic nephropathy.Methods A total of 66 patients with stage IV diabetic nephropathy who were diagnosed and treated in Beijing Dongzhimen Hospital from October 2016 to June 2017 and met the inclusion criteria were selected.According to random sampling,they were divided into the observation group with 32 cases and the control group with 34 cases.The control group was given the conventional basic treatment of western medicine,and the observation group was given the conventional basic treatment of western medicine combined with therapy for warming Yang and resolving mass(based on Zhenwu Decoction plus Chinese medicine for activating blood and resolving mass).The treatment time of the two groups was 6 months.The changes of scores of TCM syndromes,renal function[24 h urine protein quantitative,blood creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(eGFR),blood uric acid(UA)],blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],blood glucose[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c)]and blood lipids[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)],serum albumin(ALB)and hemoglobin(Hb)before and after treatment were observed in the two groups,and the efficacy of the disease,the efficacy of TCM syndromes and the occurrence of adverse reactions in the two groups were evaluated.Results Compared with before treatment,the scores of TCM syndromes and 24 h urine protein quantification in the observation group were significantly reduced after treatment(P<0.05),serum ALB levels was significantly increased(P<0.05),and the other indexes did not change significantly(P<0.05);the indexes all did not change significantly in the control group(P>0.05).Compared with the control group,the observation group had lower TCM syndrome scores,lower 24 h urine protein quantification and lower SCr level,and higher serum ALB level aft

关 键 词：糖尿病肾病Ⅳ期 温阳消癥法 真武汤 肾络癥瘕 

分 类 号：R587.1[医药卫生—内分泌]