加味真武汤治疗Ⅳ期脾肾阳虚型糖尿病肾病临床研究
Evaluation on Clinical Therapeutic Effects of Modified Zhenwu Decoction in Treating Ⅳ Stage Diabetic Nephropathy Due to Yang Deficiency of Spleen-kidney
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摘要: 目的 探讨加味真武汤治疗Ⅳ期脾肾阳虚型糖尿病肾病(DN)的临床疗效。方法 将2014年1月-2015年6月130例Ⅳ期DN患者随机分为研究组和对照组各65例,均给予常规治疗,研究组加服加味真武汤,疗程1月。比较2组治疗前后的中医证候积分、空腹血糖(FPG)、尿蛋白定量、血清肌酐(Scr)、肌酐清除率(Ccr)、收缩压(SBP)和舒张压(DBP)的改变情况,评价2组的临床疗效和安全性。结果 与对照组比较,研究组治疗后的中医证候积分、FPG、尿蛋白定量、Scr、Ccr、SBP和DBP降低更为明显,差异均具有统计学意义(P<0.05~0.01)。研究组总有效率为90.77%,明显高于对照组的67.69%,P<0.05。2组治疗期间均未见严重的不良反应。结论 在常规治疗基础上给予加味真武汤,能明显改善Ⅳ期脾肾阳虚型DN患者的临床症状,改善肾功能,且无副作用。Abstract: OBJECTIVE To explore the clinical therapeutic effects of Jiawei Zhenwu Decoction in treating IV stage diabetic nephropathy(DN) due to yang deficiency of spleen-kidney. METHODS 130 cases with DN at stage Ⅳcollected from January, 2014 to June, 2015 were randomly divided into study group and control group, with 65 cases in each group. Conventional therapy were applied to both groups and based on this, patients in the study group were further given Modified Zhenwu Decoction. After the treatment for one month, changes of TCM syndrome scores, fasting blood-glucose(FPG), urine protein excretion, serum creatinine(Scr), creatinine clearance rate(Ccr), systolic blood pressure(SBP) and diastolic blood pressure(DBP) before and after treatment were observed and comparision were made between these two groups to evaluate the clinical efficacy and safety. RESULTS Compared to the control group, there were more evident declines of TCM syndrome scores, FPG, urine protein excretion, Scr, Ccr, SBP and DBP in the study group after treatment, with statistical differences(P<0.05). The total effective rate of study group was 90.77%, which was much higher than that of 67.69% in the control group, and there were statistical differences between two groups(P<0.05). No serious side effects were noticed during the treatment in both groups. CONCULSION Conventional therapy plus Modified Zhenwu Decoction can evidently improve clinical symptoms and kidney function of patients with IV stage DN due to yang deficiency of spleen-kidney, with no side effects.
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[1] 王佑清,喻飞,王生忠,等.糖化血红蛋白与尿微量白蛋白联合检测诊断早期糖尿病肾病价值[J].中华实用诊断与治疗杂志,2012, 26(5):481-482. [2] Wang YQ, Yu F, Wang SZ, et al. Clinical value of assessment on glycated hemoglobin and microalbuminuria in diagnosing early stage diabetic nephropathy[J]. J Pract Diagn Ther, 2012, 26(5):481-482. [3] 霍美凤.β2-微球蛋白在糖尿病肾病早期诊断中的价值[J].中华全科医学,2012, 10(12):1939-1940. [4] Huo MF. Early diagnostic value of β2-microglobulin in nonage diabetic nephropathy[J]. Chin J General Pract, 2012,10(12):1939-1940. [5] 景婧,庞博,王颖辉,等.糖尿病肾病Ⅲ-Ⅴ期中医证候演变规律研究[J].北京中医药,2011, 30(12):888-890. [6] Jing J, Pang B, Wang YH, et al. Research on evolution rule of TCM syndrome in patients with Ⅲ-Ⅴ stage diabetic nephropathy[J]. Beijing J Tradit Chin Med, 2011, 30(12):888-890. [7] 周迪夷,赵进喜,牟新,等.糖尿病肾病分期证候分布与聚类分析探索[J].世界中医药,2012, 7(6):537-539. [8] Zhou DY, Zhao JX, Mou X, et al. Exploration on distribution of stage based TCM syndrome of diabetic nephropathy and clustering analysis[J].World Chin Med, 2012, 7(6):537-539. [9] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国医学前沿杂志(电子版),2015, 30(3):26-89. [10] Chinese Diabetes Society. Prevention guidance for Chinese patients with type 2 diabetes(2013 version)[J]. Chin J Front Med Sci: Electr Edit, 2015, 30(3): 26-89. [11] Mogensen C. Management of early nephropathy in diabetic patients[J]. Annu Rev Med, 1995, 46(1): 79. [12] 中华中医药学会.糖尿病肾病中医防治指南[J].中国中医药现代远程教育,2011, 9(4):151-153. [13] China Association of Chinese Medicine. Traditional Chinese medicine prevention guidelines for diabetic nephropathy[J]. Chin Med Modern Dis Edu Chin, 2011, 9(4):151-153. [14] 中国中西医结合学会糖尿病专业委员会.中西医结合糖尿病诊疗标准(草案)[J].中国中西医结合杂志,2005, 25(1):94-95. [15] Diabetes Professional Committee of China Society of Integrated Traditional Chinese and Western Medicine. Standard for diagnosis and therapeutic effect evaluation of diabetes mellitus by integrative Chinese and Western medicine (draft)[J]. Chin J Integr Tradit West Med, 2005, 25(1):94-95. [16] 中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:296-298. [17] Guiding Principles for Clinical Study of New Chinese Medicines[M]. Beijing: China medical science press, 2002:296-298. [18] 曾伟平,徐孝容,柳清.真武汤对糖尿病肾病患者血管内皮生长因子及尿蛋白排泄率的影响[J].世界中医药,2015, 10(9):1351-1354. [19] Zeng WP, Xu XR, Liu Q. The effects of Spleen-Yang Strengthening Decoction on vascular endothelial growth factor and urinary protein excretion rate in patients with diabetic nephropathy[J].World Chin Med, 2015,10(9):1351-1354. [20] 徐中菊,张悦,舒适,等.真武汤对链脲佐菌素所致大鼠糖尿病肾病的保护作用[J].中国病理生理杂志,2014, 30(9):1677-1681. [21] Xu ZJ, Zhang Y, Shu S, et al. Protective effects of Zhenwu Decoction on kidney injury of diabetic rats induced by streptozotocin[J]. Chin J Pathophysiol, 2014, 30(9): 1677-1681.
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