【作者】 王倩；

【导师】 谢桂权；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2005， 硕士

【摘要】 目的 糖尿病肾小球硬化(即糖尿病肾病)是糖尿病常见的微血管并发症,因糖尿病肾病尿毒症死亡者约占DM病人的27%-31%,成为21世纪威胁人类健康的重要疾病,迄今为止尚无有效方法防止其发展和恶化。医学界正在积极寻求防治糖尿病肾病的有效方法,本研究的目的是对本院谢桂权教授的益气养阴、祛瘀生新法抗糖尿病肾小球硬化的疗效作一观察和探讨,初步揭示该法的作用机理,为中医药防治糖尿病肾小球硬化提供新的治疗方法,为进一步开发药物提供科学的理论、临床依据。 设计 采用随机、对照的临床研究。 方法 严格按照纳入标准选择病例40人,按1:3随机分为对照组和治疗组。两组均接受必要的中西医常规治疗,治疗组在对照组基础上加服益气养阴、祛瘀生新之中药汤剂(黄芪20-30g、桑椹子15-20g、玄参10-15g、麦冬10-15g、当归10-15g、丹参15-20g、大黄6-10g、玉米须30g、川芎10g,必要时随证加味),及金水宝胶囊3粒tid或百令胶囊5片tid口服,对照组不予服用。疗程3个月,观察两组治疗前后症状、体征积分、常规实验室指标、糖尿病肾小球硬化相关细胞因子变化。 结果 益气养阴、祛瘀生新法能够有效改善气阴两虚,瘀阻肾络的临床症状及体征,两者比较以气阴两虚证改善明显;从单项症候来看,以腰膝酸软、神疲乏力、舌有瘀斑点疗效最明显(P<0.01);能够降低24小时尿蛋白定量、血糖及血脂水平(P<0.05),能够较明显地改善DN肾功能不全代偿期及失代偿期的肾功能指标(P<0.05),提高肾功能总有效率(P<0.05);可改善血液流变学,在一定程度上降低红细胞压积、全血粘度低切与纤维蛋白原(P<0.05);配合益气养阴、祛瘀生新治疗可使ET-1指标得到一定改善(P<0.05)。 结论 本研究提示DN患者广泛存在血液动力学、血糖及脂质代谢、细胞免疫方面的紊乱,而益气养阴,祛瘀生新中药能够明显减轻气阴两虚,瘀阻肾络的临床症候;能够降低血糖、血脂、纤维蛋白原、24小时尿蛋白定量,改善血液流变学、更多还原

【Abstract】 [Objective]:Diabetic glomerular sclerosis (also called Diabetic nephropathy) is one of common complication of micro-blood vessel disease, the patients who die of uremia in DN is about twenty-seven to thirty-one percent of DM, so it has became a severe disease to human being health in twenty-one century. We haven’t effective therapy to prevent its development and deterioration by now. Doctors are now finding available ways to prevent and cure DN actively. The objective of this research was to observe and discuss on curative effect of DN with replenishing qi and nourishing yin, removing stasis and promoting new which created by professor Xie Gui Quan, and display the functional method of this therapy preliminarily so that it could provide new therapy to prevent DN, offer scientific theory and clinical proof to develop medicament further.[Project]:The random, control clinical research.[Method]:Forty patients who were selected by entrance standards were classified into control group and treating group in the proportion of one to three. Both groups were routinely treated by Traditional Chinese Medicine (TCM) and western medicine. In addition, the treating group was treated with prescription of replenishing qi and nourishing yin, removing stasis and promoting new formula (including: Astragalus Root 20-30g, mulberry 15-20g, Chinese Angelica Root 10-15g, Erysipelas 15-20g, Rhubarb 6-10g, Cron stigma 30g, Chuanxiong Rhizome 10g, necessarily, add some other herbal medicine according to different symptoms), Jin Shui Bao capsule, three granules once, tid, or Bai Ling capsule,更多还原