摘要
目的：客观地评价健脾补肾法治疗糖尿病肾病脾肾气虚证患者的临床疗效及安全性,并初步探讨其作用机制,为临床治疗糖尿病肾病提供新的治疗途径和可靠依据。
方法：选择临床诊断为糖尿病肾病Ⅲ-Ⅳ期、中医辨证属脾肾气虚的患者50例,将其随机分为两组。两组均采用西医常规治疗,治疗组(25例)加服健脾补肾中药方剂。分别观察两组患者治疗前后主要临床症状、体征和实验室指标的变化,观察时间为12周。
结果：1综合疗效：治疗组的临床总有效率达到92%,明显优于对照组的32%,两组组间对比具有显著性差异(P<0.001)。2.改善临床症状、降低实验室指标方面：研究结果显示两组均能不同程度减轻糖尿病肾病患者临床症状体征,调节血糖、血脂,降低24h尿蛋白定量、胱抑素C等相关指标；其中治疗组在改善临床症状,降低胆固醇、甘油三酯,降低24h尿蛋白定量、胱抑素C等方面,效果明显优于对照组,差异具有统计学意义(P<0.05)。
结论：健脾补肾方能明显改善Ⅲ一Ⅳ期糖尿病肾病患者的临床症状和体征,调节脂类代谢,明显减少患者尿蛋白的排泄,降低胱抑素C水平、改善肾功能,延缓糖尿病肾病的的进一步发展。其疗效优于单纯西医治疗组,且未见明显不良反应。
Object:Objectively evaluate the method of nourishing kidney and Invigorating spleen to treat Diabetic Nephropathy of spleen and kidney deficiency syndrome of clinical efficacy and safety, preliminary discussion on its mechanism, in order to offer clinical treatment of diabetic nephropathy new remedial approach and reliable basis.
Methods: This study included 50 patients who were diagnosed for diabetic nephropathy in phaseⅢ～Ⅳwith spleen and kidney deficiency, they were further divided into two groups randomly. Both groups are treated with regular modern medicine. Besides the normal treatment, the treatment group(25) was added the decoction. Twelve weeks later,the changes of clinical symptom and laboratory index were examined.
Result:1.The total effect of the treatment group is 92%, and the contrast group is 32%,there is a significant difference (P<0.001).2.The two groups all can alleviate clinical symptoms; reduce blood glucose, blood lipid,urine protein, CysC, etc. However, the effect of the treatment group is much better than the control group at alleviating clinical symptoms; lowering cholesterol, triglyceride, urine protein, CysC(P<0.05).
Conclusion:the method of nourishing kidney and Invigorating spleen can improve clinical symptoms of DN patients in phaseⅢ～Ⅳobviously, correct lipid metabolic disorders,reduce the urinary protein significantly, adjust the function of renal,and finally prevent the progression of DN. It has better efficacy and less adverse reactions than western medical treatment.
引文
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