真武汤合五苓散治疗糖尿病肾病水肿的临床研究

发布时间：2018-01-06 07:40

本文关键词：真武汤合五苓散治疗糖尿病肾病水肿的临床研究　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过对60例阳虚水湿瘀阻型的糖尿病肾脏疾病水肿的患者进行临床治疗与观察,着重从中医治疗方面入手,观察在西医基础治疗上灵活运用真武汤与五苓散合方加减治疗糖尿病肾病引起的双下肢水肿的临床疗效,从而为糖尿病肾病的病证结合治疗提供临床依据,丰富和拓展糖尿病肾病患者水肿方面的治疗方法,为临床研究开拓新的思路。方法:选取2016年4月至2017年1月期间在我院门诊及住院部就诊的糖尿病肾脏疾病以双下肢水肿为主的(阳虚水湿瘀阻型)患者60例,在严格的前瞻性双盲随机对照研究的基础上平均分为两组(治疗组和对照组),每组各30例。对照组在降压、降脂、降糖等基础西药治疗基础上给予呋塞米片口服40mg,Bid;治疗组在西医基础治疗上给予真武汤与五苓散合方加减,疗程均为2周,治疗前后分别对患者的安全性指标及实验室指标进行1次记录,对患者中医症候、水肿程度分别进行判断,做好记录,待观察结束用后SPSS22.0统计软件对所记录的各项指标进行统计学分析、处理。在治疗的2周内对患者曾出现的不良反应、异常指标做好记录。成果:研究结果显示,治疗组总有效率为83.3%,对照组的总有效率60.0%,中药治疗组的疗效要显著优于对照组。治疗前后两组的中医症候积分上(P0.05)因此二者存在差异,且治疗组优于对照组。治疗前后两组患者的实验室指标方面,经治疗后患者空腹及餐后血糖水平、24h尿蛋白定量、血肌酐、尿素氮较治疗前均有所下降,治疗组下降程度更优。两组的安全性指标方面均没有出现明显不良反应及异常指标。结论:在西医基础治疗上灵活用真武汤五苓散合方加减治疗早期糖尿病肾病引起水肿可明显改善患者的临床症状及中医症候表现(肢体浮肿、畏寒、小便不利、少气懒言等),且能明显提高糖尿病肾病以双下肢水肿为主的(阳虚水湿瘀阻型)患者的临床疗效,还能降低患者的空腹血糖、餐后2h血糖、24h尿蛋白定量、BUN、Scr等实验室指标,表明灵活运用经方辨证治疗阳虚水湿瘀阻型早期糖尿病肾病双下肢有明显的疗效且安全性较高,暂时取得了比较满意的效果,今后仍需进一步的补充、证实与完善。
[Abstract]:Objective: to study the clinical treatment and observation of 60 cases of diabetic renal disease edema caused by Yang deficiency and water dampness and stasis, and to focus on the treatment of traditional Chinese medicine (TCM). To observe the clinical efficacy of Zhenwu decoction and Wuling Powder decoction in the treatment of edema of both lower limbs caused by diabetic nephropathy, and to provide the clinical basis for the combined treatment of disease and syndrome of diabetic nephropathy. Enrich and expand the treatment of diabetic nephropathy patients with edema. Methods: from April 2016 to January 2017, diabetic kidney diseases in outpatient and inpatient departments of our hospital were mainly caused by edema of the lower extremity (. There were 60 patients with Yang deficiency and water dampness and stagnation. On the basis of a strict prospective double-blind randomized controlled study, the average was divided into two groups (treatment group and control group, 30 cases in each group. On the basis of treatment of hypoglycemic and other basic western medicine, furosemide tablets were given orally for 40mg Bididin; The treatment group was treated with Zhenwu decoction and Wuling Powder decoction for 2 weeks. Before and after treatment, the safety index and laboratory index of patients were recorded for 1 time, and the symptoms of TCM were recorded. The edematous degree was judged and recorded, and the SPSS22.0 statistical software was used to statistically analyze the indexes after observation. Treatment. In the treatment of 2 weeks of adverse reactions, abnormal indicators to make a good record. Results: the results of the study showed that the total effective rate of the treatment group was 83.3 percent, the total effective rate of the control group was 60.0%. Traditional Chinese medicine treatment group is significantly better than the control group. The two groups before and after treatment of traditional Chinese medicine symptoms score P0.05) so there is a difference between the two groups. And the treatment group is better than the control group. Before and after the treatment of the two groups of patients' laboratory indicators, after the treatment of fasting and postprandial blood glucose levels of 24 hours urine protein quantitative, blood creatinine, urea nitrogen compared with the treatment before and after treatment have decreased. There were no significant adverse reactions and abnormal indexes in both groups. Conclusion:. The flexible use of Zhenwu Tang Wuling Powder decoction in the treatment of edema caused by early diabetic nephropathy can obviously improve the clinical symptoms and symptoms of traditional Chinese medicine (. Puffy limbs. It can obviously improve the clinical efficacy of diabetic nephropathy with edema of both lower extremities (Yang deficiency and water dampness stasis type) and can also reduce the fasting blood glucose of the patients. 2 h postprandial blood glucose and 24 h urinary protein were measured by BUNN SCR and other laboratory indexes. The results indicated that the flexible use of Meridian prescription in treating early diabetic nephropathy with Yang deficiency and water dampness stasis had obvious curative effect and high safety, and achieved satisfactory results temporarily, which still needed to be further supplemented in the future. Verification and perfection.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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