补肾化瘀方治疗2型糖尿病肾病肾虚瘀阻证的临床研究

【作者】 王玉成；

【导师】 王旭；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2005， 硕士

【摘要】 目的：探讨补肾化瘀方对2型糖尿病肾病(diabetic nephropathy，DN)的临床疗效及作用机理。 方法：对中医学与西医学研究2型糖尿病肾病的现状与进展进行了全面的综述，通过系统的历史回顾和分析，根据传统中医理论，提出肾虚瘀阻为糖尿病肾病的重要病理机制，确定补肾化瘀治则，并拟补肾化瘀方。 对45例2型糖尿病肾病患者随机分为治疗组24例及对照组21例，两组均在饮食管理、运动指导、西药降糖的基础上，治疗组同时予口服中药汤剂补肾化瘀方，对照组予血管紧张素转化酶抑制剂卡托普利，治疗3个月后两组比较，总结疗效。 观察患者尿微量白蛋白、尿素氮、肌酐；体外血栓形成试验；空腹血糖及餐后2小时血糖、糖化血红蛋白、(糖化血红蛋白以氨基酮化合物所占百分率表示)；甘油三酯、胆固醇、低密度脂蛋白、高密度脂蛋白等指标。 结果：治疗前两组患者临床症状体征、尿微量白蛋白、尿素氮、肌酐、体外血栓形成试验、血糖、糖化血红蛋白、血脂等指标无统计学差异(P＞0.05)，具有可比性。经过3个月的治疗后，补肾化瘀方对糖尿病肾病的总有效率为83.33％，对照组总有效率为76.19％。治疗组前后比较提示：治疗后尿微量白蛋白排泄率、血肌酐、尿素氮下降；血糖、血栓形成试验、血脂紊乱状态得到改善(P＜0.05)。血糖、血栓形成试验及甘油三酯改善，治疗组优于对照组，有显著性差异(P＜0.05)，示补肾化瘀方具有良好降微量白蛋白、改善肾功能、血黏度、降低血糖、改善脂代谢作用。 结论：补肾化瘀方是治疗2糖尿病肾病有效方药，能改善糖尿病肾病患者临床症状、减少尿蛋白排泄、改善肾功能和血黏度、降低血糖、调节血脂代谢，有效地延缓和控制糖尿病肾病的自然进程，提高糖尿病肾病患者的生活质量。更多还原

【Abstract】 Objective To observe the clinic effect of bushenhuayu on early the type 2 diabetic nephropathy (DN).Methods 45 patients with DN were divided at random into treatment group (24cases) and control group (21cases). All patients were treated with dietary management, kinesitherapy and hypoglycemic therapy; while the treatment group were administered with the traditional Chinese medicine of bushenhuayu and the control group were administered with ACEI(Captopril) for 3 months.There had been observed umAlb, Bun, Scr, thrombosis test, FPG 2hPPG, HbA1c, TG, TC, LDL-C, HDL-C of the 45 patients Results The result showed that after the 3 months treatment, the total cure effective rate to the early DN was83.33%, The treatment of bushenhuayu can reduce the excretion of urine protein compared the data before the treatment and can also be equal to t he control group treated with ACEI.Before the treatment, there are no significant statistics divergence in urine protein, thrombosis test, plasma glucose, lipid, between the treatment group and the control group(P>0.05) , After treatment, microalbumin, plasma glucose, thrombosis test and cholesterol reduced significance of difference Before the treatment, the patient’s was in dyslipidemia to some degree. After the treatment, dyslipidemia was更多还原