益气养阴通络方联合祛风湿法治疗糖尿病肾病疗效观察  

Therapeutic Effect of Yiqi Yangyin Tongluo Decoction Combined with Dispelling Wind and Dampness on Diabetic Nephropath

作　　者：袁博寒[1] 陈洪宇[1] 郑峰 YUAN Bohan;CHEN Hongyu;ZHENG Feng(Traditional Chinese Medicine Hospital Hangzhou,Zhejiang Province,Hangzhou,310006)

机构地区：[1]浙江省杭州市中医院,杭州310006

出　　处：《中国中西医结合肾病杂志》2020年第12期1051-1054,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：浙江省中医药科技计划项目(No.2014ZQ022,No.2018ZA086)。

摘　　要：目的:观察糖尿病肾病中医证候并验证益气养阴通络方联合CKD协定方治疗糖尿病肾病疗效。方法:90例糖尿病肾病患者随机分为对照组、中药组和祛风湿组。治疗12周,观察治疗前后中医证候学及实验室指标变化。结果:治疗后中药组、祛风湿组中医证候积分较治疗前明显下降(P<0.01),与对照组相比差异有统计学意义(P<0.01)。祛风湿组治疗后24 h尿蛋白定量较治疗前明显下降(P<0.01),其治疗前后差值与对照组及中药组比较均有统计学意义(P<0.01)。对照组治疗后血肌酐较治疗前明显升高,中药组和祛风湿组血肌酐基本稳定(P>0.05)。在CKD4期患者中祛风湿组血肌酐治疗前后差值与对照组比较明显下降(P<0.05)。各组治疗前后谷丙转氨酶及血白细胞差异无统计学意义(P>0.05)。结论:风湿证候是推动糖尿病肾病进展的重要病机;益气养阴通络方联合CKD协定方能减少糖尿病肾病患者蛋白尿,延缓肾功能恶化,且能有效改善患者中医证候,提高患者生存质量,未见明显不良反应。Objective:To observe the TCM syndromes of diabetic nephropathy and verify the efficacy of Yiqi Yangyin Tongluo Decoction combined with CKD prescription in the treatment of diabetic nephropathy.Methods:Ninety patients with diabetic nephropathy were randomly divided into the control group,the Chinese medicine group and the Qufengshi group.Observe the changes in TCM syndromes and laboratory indicators before and after treatment for 12 weeks.Results:The scores of TCM syndromes of the Chinese medicine group and Qufengshi group after treatment were significantly lower than those before treatment(P<0.01),and there was a statistical difference compared with the control group(P<0.01).In the Qufengshi group,24 h protein quantification after treatment was significantly lower than before treatment(P<0.01),and the difference before and after treatment was statistically different from that of the control group and the Chinese medicine group(P<0.01).After treatment,the serum creatinine in the control group was significantly higher than before treatment.The blood creatinine in the Chinese medicine group and the rheumatism group was basically stable,but there was no statistical difference between the groups(P>0.05).In patients with stage CKD4,the difference between serum creatinine before and after rheumatism was significantly lower than that in the control group(P<0.05).There was no significant difference between alanine aminotransferase and leukocyte before and after treatment in each group(P>0.05).Conclusion:Rheumatism syndrome is an important pathogenesis to promote the progression of diabetic nephropathy;Yiqi Yangyin Tongluo Decoction combined with CKD prescription treats diabetic nephropathy,which has exact effects on reducing proteinuria,stabilizing renal function,and delaying deterioration of renal function,and is effective Improved TCM syndromes and quality of life of patients,no obvious adverse reactions were seen.

关 键 词：糖尿病肾病 风湿证候 中医药 益气养阴通络 祛风湿 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]