桂枝茯苓丸合四味健步汤加味治疗糖尿病肾病的临床研究  

Clinical study on treating diabetic nephropathy by flexible using Guizhi Fuling pill and Siwei Jianbu decoction

作　　者：林素珍 陈宇[1] LIN Suzhen;CHEN Yu(Department of Nephrology,Wenzhou TCM Hospital of Zhejiang Chinese Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]浙江中医药大学附属温州市中医院肾病科,浙江温州325000

出　　处：《中国现代医生》2024年第16期98-101,118,共5页China Modern Doctor

基　　金：浙江省温州市基础性医疗卫生科技项目(Y20211108)。

摘　　要：目的 探讨桂枝茯苓丸合四味健步汤加味治疗糖尿病肾病的疗效及其对炎症指标、高凝状态的影响。方法 选取2022年1月至12月于浙江中医药大学附属温州市中医院确诊的水瘀互结型糖尿病肾病患者78例,采用随机数字表法将其分为观察组和对照组,每组各39例。对照组患者采用西医常规综合治疗,观察组患者在对照组基础上加用桂枝茯苓丸合四味健步汤加味,总疗程8周。比较两组患者治疗前后的中医证候积分、24h尿蛋白定量、血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor α,TNF-α)、纤维蛋白原、D-二聚体、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)。结果 治疗后,两组患者的中医证候积分、24h尿蛋白定量、SCr、BUN、IL-6、TNF-α、纤维蛋白原、D-二聚体均显著低于本组治疗前(P<0.05);观察组患者的中医证候积分、24h尿蛋白定量、SCr、IL-6、TNF-α、纤维蛋白原、D-二聚体均显著低于对照组(P<0.05)。观察组患者的总有效率显著高于对照组(χ^(2)=6.241,P=0.044)。两组患者治疗后均未发生不良反应,治疗前后的肝功能指标比较差异无统计学意义(P>0.05)。结论 桂枝茯苓丸合四味健步汤加味治疗水瘀互结型糖尿病肾病疗效较好,可减轻患者的临床症状,降低24h尿蛋白定量,改善肾功能,推测与该方药减轻炎症反应、改善高凝状态有关。Objective To investigate the clinical effect of flexible using Guizhi Fuling pill and Siwei Jianbu decoction in treating the diabetic nephropathy patients,and to observe its effect on inflammatory indicators and hypercoagulabale state.Methods A total of 78 patients diagnosed with syndrome of intermin-gled water and blood stasis diabetic nephropathy in Wenzhou TCM Hospital of Zhejiang Chinese Medical University from January to December 2022 were selected and divided into observation group and control group by random number table method,with 39 cases in each group.The control group was treated with conventional western comprehensive therapy,while the observation group was treated with Guizhi Fuling pill and Siwei Jianbu decoction on the basis of control group.Both groups were treated for 8 weeks.The TCM syndrome score,24h urinary protein quantity,serum creatinine(SCr),blood urea nitrogen(BUN),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),fibrinogen,D-dimer,alanine aminotransferase(ALT),aspartate aminotransferase(AST) were compared between two groups before and after treatment.Results After treatment,the TCM syndrome score,24h urinary protein quantity,SCr,BUN,IL-6,TNF-α,fibrinogen and D-dimer in two groups were significantly lower than before treatment(P<0.05).The TCM syndrome score,24h urinary protein quantity,SCr,IL-6,TNF-α,fibrinogen and D-dimer in observation group were significantly lower than those in control group(P<0.05).The total effective rate of observation group was significantly higher than that of control group(χ^(2)=6.241,P=0.044).There was no adverse reaction between two groups after treatment,and there was no significant difference in liver function indexes before and after treatment(P>0.05).Conclusion Flexible using Guizhi Fuling pill and Siwei Jianbu decoction has a good therapeutic effect on syndrome of intermin-gled water and blood stasis diabetic nephropathy,which can reduce clinical symptoms of patients,reduce 24h urinary protein quantity and improve renal function,which is speculate

关 键 词：桂枝茯苓丸 四味健步汤 糖尿病肾病 水瘀互结证 炎症反应 高凝状态 

分 类 号：R256.51[医药卫生—中医内科学]