栗德林学术思想与临床经验总结及三甲肾消汤治疗气阴两虚瘀浊内阻糖尿病肾脏病（Ⅲ～Ⅳ期）临床研究

发布时间：2018-06-27 16:24

本文选题：经验研究 + 栗德林　；参考：《北京中医药大学》2017年博士论文

【摘要】：栗德林教授学术思想与临床经验总结栗德林教授是全国老中医药专家学术经验继承工作指导老师,教授、主任医师、博士生指导教师、博士后指导教师。他从事临床医疗、教学工作50年,熟读中医著作,博采众长,医术精湛,医德高尚,中医基础理论知识雄厚,具有丰富的临床经验。他既重视继承,又提倡发扬创新,逐渐形成了"重视脾肾,扶正祛邪,以辨应变,选经方不拘病,择时方审病性,寒热多态寻病位,药研成果要巧用"的学术思想及提出应运用生物学方法研究、用生物学语言诠释中医理论与临床等创新思想,为实现中医现代化做出了新的探索和新的贡献。学术渊源:通过对导师影响比较大的中医著作及名老中医的学术思想进行研究分析,以及了解导师的学医经历,探求栗德林教授的学术渊源。中医典籍1《黄帝内经》中病因病机、辨证论治理论对栗教授学术思想的形成有指导意义。①审察病机,治病求本—以辨应变,辨证精确;②阴阳失调,寒热理论—寒热多态寻病位;③《内经》中对消渴病的论述对栗德林教授认识消渴病的病因病机和治疗消渴病有重要指导作用。2《伤寒杂病论》中的辨证论治方法、寒热错杂理论对栗德林教授"以辨应变"、"选经方不拘病"、"寒热错杂寻病位"学术思想的形成有深远影响。3《医宗金鉴》中杂病心法要诀、妇科心法要诀和外科心法要诀对栗教授临床治疗经验的影响重大。《医宗金鉴·杂病心法要诀》中辨证论治理论和选方对栗教授治疗内科杂病有重要指导意义。栗教授治疗妇科病重视调理气血,疏肝理气,健脾益气,补血活血调经,选方亦多崇《医宗金鉴·妇科心法要诀》;《医宗金鉴·外科心法要诀》中皮肤病论治理论和选方对栗教授治疗皮肤病颇有启发。4《温热论》中卫气营血辨证论治理论对栗教授治疗温热病临床经验的形成起着重要的指导作用。5《医林改错》中立足于气血辨证而创制的诸多逐瘀方剂,对栗教授治疗瘀血证有重要指导意义;《医林改错》"灵机记性,不在心在脑"之说,对栗教授辨治情志疾病(抑郁症)及老年性脑病(脑萎缩、老年性痴呆)颇有启发。6《医学衷中参西录》中衷中参西的治学观点和实验研究的方法对栗教授重视发扬创新、提倡药研成果要巧用的学术思想的形成产生了深远的影响;书中主治"虚劳"的十全育真汤对栗教授治疗慢性原发性肾小球疾病有重要启发意义。学医经历栗德林教授的学医经历可概括为"三阶段、七从"。"三阶段"即在校阶段、临床阶段、提升阶段;"七从"即从书本、从实践、从中西融合、从医案、从科研、从教学、从时势。这些学习经历对他今后学术思想的形成打下坚实基础,并产生重要的影响。名老中医学术思想1高仲山:受高老影响,栗教授重视运用《伤寒论》及《温热论》之方,重视西医理论知识的学习和运用,巧妙运用药理研究成果,积极进行科研试验、开发新药。2马骥:治疗肾系疾病多以扶正祛邪为原则,标本兼顾;治疗消渴病以益气养阴、活血化瘀为基础,根据兼证配合其他治法。3张琪:治疗肾病注重整体,尤以脾肾为重,辨治疑难病症以气血生变为要。4于盈科:在妇科病治疗中重视调理气血,善于运用虫类药,选方多崇《医宗金鉴妇科心法要诀》。5白郡符:以脏腑、经络、气血辨证为基础,选方用药灵活多变,影响了栗教授"以辨应变,选经方不拘病,择时方审病性"学术思想的形成。栗德林教授学术思想总结:1重视脾肾,扶正祛邪重视调补脾肾,扶正祛邪。2以辨应变,辨证精确强调要在病情变化中精确辨证,才能正确立法处方,取得佳效。3选经方不拘病,择时方审病性强调要在辨证精确的基础上选用经方、时方。4寒热多态寻病位寒热错杂证广泛存在并且形式多样,在辨证上应首先辨清寒热的病位,然后正确立法遣方。5药研成果要巧用重视对中药现代药理研究成果的运用,既重视辨证,又重视辨病。栗德林教授临床经验整理与总结(附典型医案)1肺系疾病:急性者以六经、卫气营血与三焦辨证为主,慢性者以脏腑辨证分证论治为主。治法以宣、清、降、泻、润、补、敛、化为主,健脾补肺,通腑相济为用。流感分邪在肺卫型、肺热雍盛型、胃肠失调型、邪在营血型论治。肺痈以成痈期与溃脓期多见,治疗也最为关键。成痈期采用清热解毒、肃肺化瘀之法,以千金苇茎汤加味治疗。2脾胃病:构建寒热错杂在疾病发展变化中多态性理论治疗脾胃病。慢性萎缩性胃炎以寒热并用、辛开苦降立法,用半夏泻心汤加减治疗。溃疡性结肠炎以补中升阳兼清热化湿为法,以升阳益胃汤为基础加减,研制出肠炎宁胶囊治疗。3肾系疾病:治疗肾病攻补结合。慢性原发性肾小球疾病以益气养阴、活血利湿为法,以十全育真汤为基础加减研制出十全育真胶囊治疗。慢性肾盂肾炎以益气补肾为主,兼祛余邪,创立"益肾康方"治疗。难治性肾病综合征以通络活血、祛瘀生新、泄湿解毒为法,方选大黄嚺虫丸治疗。4郁证:分型论治:①肝气郁结,治以柴胡疏肝散加减;②血行郁滞,治以通窍活血汤合四逆散加减;③胆郁痰扰,治以温胆汤加减;④忧郁伤神,治以甘麦大枣汤加味;⑤心脾两虚,治以归脾汤加减;⑥肾虚肝郁,治以六味地黄汤合柴胡疏肝汤加减。5痹证:痹证辨治首先应分析病位深浅,其次辨识病性,包括新久虚实,体质差异及病邪性质,分清风寒湿痹和热痹的不同。风寒湿痹用自拟二龙蠲痹汤;风湿热痹用当归拈痛汤加减;正虚湿热用木防己汤加减;久痹肾虚用独活寄生汤加减。6痫证:痫证以心脑神机失用为本,风火痰瘀致病为标,尤以瘀血痰邪作祟最为重要。治疗采用活血化瘀通窍、化痰豁痰通窍、疏肝柔肝熄风、清肝镇肝熄风、益气补血通络之法。选方常用通窍活血汤、黄芪桂枝五物汤、补阳还五汤、礞石滚痰丸、温胆汤。7痴呆:分型论治:①髓海不足,治以六味地黄丸加减;②气虚血瘀,治以黄芪桂枝五物汤合补阳还五汤加减;③心肝火旺,治以龙胆泻肝丸合牛黄清心丸(局方)加减;④痰浊阻窍,治以涤痰汤合温胆汤加减;⑤瘀血阻窍,治以通窍活血汤加减。8脉痹(雷诺氏病):本病的发生多与血虚受寒,经脉阻滞有关,以活血补血、温经散寒为主要治法,以当归四逆汤为基础方加减治疗。9瘿病:分型论治:①气郁痰阻型,治以四海舒郁丸加减;②痰结血瘀型,治以海藻玉壶汤加减;③肝胃火盛型,治以栀子清肝汤合藻药散加减;④心肝阴虚型,治以天王补心丹加减。10糖尿病及其并发症:糖尿病基本病因病机可概括为"五脏柔弱、内热熏蒸、伤津耗气、血稠液浓"。糖尿病并发冠心病病因病机为"五脏柔弱、内热熏蒸、伤津耗气、血稠液浓、瘀阻痰凝",治以益气养阴、活血化痰为法,方用自拟芪玄益心汤。糖尿病周围神经病变病因病机为"五脏柔弱、内热熏蒸、伤津耗气、血稠液浓、瘀血阻络",治以益气养阴、活血通络,佐以燥湿祛痰化浊为法,方用自拟芪玄通络汤。栗德林教授治疗糖尿病用药规律聚类分析背景:糖尿病作为一种终生进展性疾病,其防治工作面临严峻挑战。栗德林教授多年来潜心研究糖尿病及其并发症的中医药治疗,积累了丰富的临床经验,其研究出自拟经验方,在治疗糖尿病方面取得了显著的疗效。本研究收集整理了近3年来栗教授治疗糖尿病的典型病例,利用频次分析和聚类分析的方法总结其处方用药规律。研究目的:采用数据挖掘方法分析栗德林教授治疗糖尿病的治疗思路和用药规律,总结栗教授治疗糖尿病的经验。研究方法:收集整理栗德林教授治疗糖尿病的典型病例,通过数据库对处方中使用的药物进行频次分析和聚类的方法分析,对栗教授治疗糖尿病的经验进行总结。研究结果:选择栗德林专家门诊糖尿病患者80例(复诊≥3次)、共计436诊次的处方资料,其中单味药使用频率10%的中药有29味,前5位分别为黄芪、黄连、丹参、葛根、灵芝。常用药物中补虚药、清热药、解表药、收涩药为常用类别,药性中构成比最高的为平性(31.03%),药味中构成比最高的为甘味(79.31%),药物归经中构成比最高的为肺经(48.28%)。29味药物按药性聚为10类时临床意义清晰。结论:通过对数据库的挖掘,总结出自拟芪黄消渴汤为栗教授治疗DM的核心处方,使用药物多为平寒、甘苦之品,重视运用补法和清法,认为气阴两虚兼燥热血瘀为DM主要证型,以益气养阴清热、佐以活血化瘀为治疗大法。三甲肾消汤治疗气阴两虚瘀浊内阻糖尿病肾脏病(Ⅲ～Ⅳ期)临床研究第一部分文献综述(2篇):第1篇糖尿病肾脏病的现代医学研究进展,对近十年来糖尿病肾脏病的发病机制、早期的诊断、西医治疗方面的研究进行回顾。第2篇中医药治疗糖尿病肾脏病的研究进展,回顾了近十年来对糖尿病肾脏病的中医病名探讨、病因病机、辨证论治、问题与展望方面的研究。第二部分临床研究:三甲肾消汤治疗气阴两虚瘀浊内阻糖尿病肾脏病(Ⅲ～Ⅳ期)临床研究研究目的:观察三甲肾消汤治疗气阴两虚瘀浊内阻糖尿病肾脏病(Ⅲ～Ⅳ期)的临床疗效及其使用的安全性。研究方法:80例患者按随机数字表法分为对照组、治疗组。对照组:基础治疗加洛汀新治疗。治疗组:基础治疗加三甲肾消汤治疗。治疗组和对照组分别治疗8周。治疗前后对两组中医症状体征积分、24小时尿蛋白定量、肾功能指标、血糖、糖化血红蛋白、血脂、血液流变学及安全性指标进行观察。研究结果:1、对照组的总有效率为70%,治疗组的总有效率为85%,两组比较差异有统计学意义(P＜0.05);2、治疗组治疗后CHOL、TG下降(P0.05),对照组治疗后仅TG下降(P＜0.05),两组TG下降的差值比较,有统计学意义(P0.05);3、治疗后治疗组全血低切相对粘度、全血低切还原粘度、血浆粘度、红细胞聚集指数均下降(P0.05),对照组治疗后全血低切相对粘度、血浆粘度下降(P0.05),两组全血低切相对粘度、血浆粘度的下降差值比较,有统计学意义(P0.05);4、治疗后两组的24h尿蛋白定量与治疗前比较均有下降,两组下降差值比较有统计学意义(P0.05);5、治疗组治疗后血肌酐、血尿素氮较治疗前下降,肾小球滤过率较治疗前增加,差异有统计学意义(P0.05),对照组治疗后肾小球滤过率、血肌酐、血尿素氮较治疗前均无明显变化(P0.05),两组治疗后血尿酸均无明显变化;6、治疗组的症状体征平均总积分较治疗前明显下降,有统计学意义(P0.05),对照组的症状体征平均总积分较治疗前下降,但无统计学意义(P0.05);7、临床观察过程中未出现任何毒副作用。结论:栗德林教授经验方能够明显改善气阴两虚瘀浊内阻糖尿病肾脏病(Ⅲ～Ⅳ期)患者的症状,显著降低蛋白尿,改善肾功能,具有良好的安全性。
[Abstract]:Professor Li Delin's academic thought and clinical experience summed up professor chestling, a tutor, Professor, chief physician, doctoral instructor, postdoctoral instructor, and a postdoctoral instructor. He is engaged in clinical medical treatment, teaching work for 50 years. He is familiar with traditional Chinese medicine works. The basic theory is rich in knowledge and has rich clinical experience. He not only attaches importance to inheritance, but also advocates the development of innovation. He has gradually formed the academic thought of "attaching importance to the spleen and kidney, helping Zheng and dispel evil, choosing the time to be unconditional, choosing the time to examine the disease, the cold and heat polymorphic finding position, the research results should be used skillfully" and put forward to use biological methods to study and use biological language. It is a new exploration and new contribution to the realization of traditional Chinese medicine modernization. The academic origin: the research and analysis of the traditional Chinese medicine and the academic thought of the famous old Chinese medicine, and the academic history of the tutor, and the academic origin of Professor chestin, 1<. The theory of syndrome differentiation and treatment in the Yellow Emperor's internal classics has guiding significance for the formation of Professor Chestnut's academic thought. (1) examination of the pathogenesis and treatment of diseases, to distinguish the strain, and to distinguish the accurate; (2) the misalignment of yin and Yang, the cold and heat theory of cold and heat polymorphisms, and the discussion on the etiology, pathogenesis and treatment of Professor chestin's thirst disease in the inner Sutra Xiaoke disease has an important guiding role in the theory of syndrome differentiation and treatment in the theory of.2< typhoid and miscellaneous diseases. The theory of cold and heat miscellaneous miscellaneous theory has a profound influence on the academic thought of "identifying the strain", "choosing the classics to be ill" and "cold and hot miscellaneous finding the disease position", which has a profound influence on the heart law key of the.3< medical Zong Jinjian, the key formula of the heart law of the Department of gynaecology and the key of the surgical heart law to Professor Li Delin. The effect of bed treatment experience is very important. The theory of syndrome differentiation and treatment in the key to the heart law of miscellaneous diseases has important guiding significance to the treatment of medical miscellaneous diseases in Chinese medicine. Professor chestnut treats gynecologic diseases and attaches great importance to regulating qi and blood, dispersing the liver and regulating qi, strengthening the spleen and enriching qi, enriching blood and activating blood and regulating menstruation. The theory of Dermatology and treatment of dermatology in the theory of Dermatology and the selected prescription for the treatment of skin diseases by Professor chestnut, the theory of febrile fever in.4< > the theory of syndrome differentiation of Qi and blood in the middle Wei Qi Ying Xue's theory on the formation of the clinical experience of febrile diseases in Professor chestnut The treatment of blood stasis has important guiding significance; < medical forest error > > "spiritual memory, no heart in the brain", Professor Chestnut's identification and treatment of emotional diseases (depression) and senile encephalopathy (brain atrophy, senile dementia) is quite enlightening to the middle and western study viewpoint and experimental research method in.6< medicine. It is important for Professor chestnut to treat chronic primary glomerular disease. The experience of Professor Li dlin's medical experience can be summed up as "three stages, seven from". "Three stages", at the school stage, clinical stage, Seven from the book, from the book, from the practice, from the Chinese and Western integration, from the medical case, from the scientific research, from the teaching to the current situation. These learning experiences have laid a solid foundation for the formation of his future academic thought and have an important influence. The famous old Chinese traditional Chinese medicine academic thought 1 Gao Zhongshan: under the influence of high old, Professor chestnut attaches importance to the use of the theory of typhoid and warm heat. According to the study and application of the theoretical knowledge of Western medicine, the results of pharmacological research are skillfully used, the scientific research experiment is actively carried out, and the new medicine.2 Ma Ji is developed. The treatment of kidney diseases is mainly based on the principle of eliminating evil and eliminating evil. The treatment of thirst disease is based on Supplementing Qi and nourishing Yin, promoting blood circulation and removing stasis, and combining with the other treatment methods, according to the syndrome, the treatment of kidney disease is focused on the whole, especially the whole, especially nephrosis. Especially the whole disease. The spleen and kidney is heavy, and the diagnosis and treatment of the difficult disease with Qi and blood is changed into.4. In the treatment of gynecopathy, it pays attention to regulating qi and blood, and is good at using insect medicine. The selection side is more highly praised for the >.5 white county character of the gynecologic center of gynaecology: Based on the viscera, meridian, Qi and blood, the selection prescription is flexible and changeable. The academic thought of "choosing the timing of the disease" is a summary of the academic thought of Professor randlin: 1 to pay attention to the spleen and kidney, to attach importance to the spleen and kidney, to pay attention to the spleen and kidney of the spleen, to correct the.2 in order to distinguish the strain, and to accurately emphasize the exact differentiation of the disease in the condition of the disease, and to obtain the right legislative prescription, to obtain the good effect of.3 to choose the classics, and to emphasize the accuracy of the syndrome differentiation and accuracy. On the basis of it, the syndrome of cold and heat disorder of the.4 cold and heat polymorphism is widely existed and varied in form. In the syndrome differentiation, the disease position of cold and heat should be identified first, and then the correct legislation for.5 research results should be used to use the modern pharmacological research results of traditional Chinese medicine. 1 lung diseases were collated and summed up (with typical medical cases): the acute one was based on six meridians, Wei Qi camp blood and three focal syndrome differentiation, and the chronic patients were mainly treated with syndrome differentiation and differentiation of Zang Fu organs. The treatment method was used in Xuan, Qing, descending, diarrhea, moistening, supplementing and converging. The lung carbuncle is more common in the period of carbuncle and depuration, and the treatment is also the most important. The treatment of carbuncle by clearing heat and detoxification, eliminating the blood stasis and treating.2 spleen and stomach disease with Qianjin reed stem soup is used to Treat Spleen and stomach disease. The treatment of ulcerative colitis with supplementing Yang and clearing heat and humidities with Shengyang Yigan Decoction on the treatment of.3 kidney disease: treatment of kidney disease and tapping and supplementing. Chronic primary glomerular diseases are treated with nourishing qi and nourishing Yin, activating blood and dampness, and taking Shiquan Zhen Tang as the basis and reducing the treatment of Shiquan Yu Zhen capsule. The treatment of chronic pyelonephritis is mainly to replenish qi and nourish the kidney and establish "Yishen Kang Fang" treatment. Refractory nephrotic syndrome is treated with dredging collaterals and activating blood, removing blood stasis and relieving detoxification as a method. The treatment of.4 depression syndrome: (1) liver qi stagnation, treatment with Radix Bupleuri, stagnation of liver and stagnation of blood, treatment with Tongqiao Huoxue Decoction and four converse powder Plus and subtract; (3) cholera phlegm disturbing, treatment with Wendan soup plus or minus; (4) melancholy and injury, treated with manmai zizzao soup plus flavor; 5 heart spleen two deficiency, treatment with Guipi Decoction plus subtraction, kidney deficiency liver depression, treatment with six flavour of Rehmannia soup combined with Chaihu Shugan soup.5 arthralgia syndrome: arthralgia syndrome differentiation and treatment first should be analyzed the depth of the disease, secondly identification of the disease, including new long and real, physical differences and pathogenic evil nature Quality, divide the wind cold wet arthralgia and heat arthralgia. The rheumatism and damp arthralgia with the self-made two dragon Juan Juan soup; rheumatism and heat arthralgia with Danggui Tong Tong Decoction plus subtract; the deficiency and damp heat use the wooden prevention soup to add and subtract; the long arthralgia kidney deficiency with the single live parasitic soup adds and subtract the.6 epilepsy syndrome: the epilepsy syndrome is lost the heart and the phlegm and blood stasis to be the mark, especially the blood stasis phlegm evil is most important. The treatment mining is most important. The method of activating blood and removing blood stasis, eliminating phlegm and phlegm, clearing the liver and extinguishing the wind, clearing the liver to extinguish the wind, improving Qi and enriching blood and dredging the blood and collaterals of blood, enriching the blood and enriching the blood and dredging the blood and collaterals of the Qi, huangqi and cinnamon branch, the five soup of the Huangqi and cinnamon branch, the Five Decoction of tonifying stone, the.7 dementia of the Wendan soup, the treatment of the deficiency of the medullary sea, the addition and subtraction of the six flavored Rehmannia pills, and the Qi deficiency and blood stasis, five Astragalus cinnamon branch Material soup combined Buyang five soup addition and subtraction; (3) the heart liver fire flourishing, treatment with dragon gentian Xie Gan pill combined with Niuhuang Qingxin pill (bureau) to add and subtract; (4) phlegm turbidity obstructing orifices, treatment with polyester phlegm soup combined with Wendan Decoction; stasis of Blood Stasis Decoction, treatment with Tongqiao activating blood soup to reduce.8 pulse Bi (Reno's disease): the occurrence of this disease is mostly with blood deficiency cold, meridian block related, blood activating blood, warm meridian spread cold On the basis of the main treatment, the treatment of.9 gall disease with Danggui four reverse decoction was treated as a basis for treatment: (1) qi stagnation and phlegm resistance type, treatment with Sihai Shu Yu pill plus reduction; (2) phlegm knot blood stasis type, treatment with seaweed jade kettle soup; (3) liver stomach fire type, treatment with gardenia Qinggan soup combined alga medicine; 4. Complications: the basic pathogenesis of diabetes can be summed up as "five dirty weak, internal heat fumigation, injury of oxime gas, thick liquid thick liquid". The pathogenesis of diabetes complicated with coronary heart disease is "five dirty weak, internal heat fumigation, injury of oxaline gas, thick liquid, blood stasis phlegm coagulation", treatment with nourishing qi and nourishing Yin, activating blood and phlegm, using self-made Qi Xuan Yixin soup. Diabetic peripheral neuropathy. The pathogenesis is "five dirty weak, internal heat fumigation, injuring oxaline consumption, thick liquid, blood stasis obstructing collaterals", treatment with nourishing qi and nourishing Yin, activating blood and dredging collaterals, using the method of drying dampness, eliminating phlegm and removing turbidity, using self-made Qi Xuan Tongluo soup. In recent years, Professor chestling has studied the TCM treatment of diabetes and its complications and has accumulated rich clinical experience. This study has made a significant effect on the treatment of diabetes. This study collects and collates the typical cases of Professor chestnut in treating diabetes in the past 3 years. The method of clustering analysis was used to summarize the rule of prescription drug use. The purpose of this study was to use data mining method to analyze the treatment ideas and rules of treatment of diabetes by Prof. chestin, and to summarize the experience of Professor chestnut in the treatment of diabetes. The experience of Professor chestnut in the treatment of diabetes was summed up by the analysis of frequency analysis and clustering method. The results were as follows: 80 cases of diabetic patients in chestnut specialist outpatient (more than 3 times) were selected, with a total of 436 times of the prescription, of which 10% of traditional Chinese Medicine had 29 flavors and the first 5 were Astragalus, Rhizoma Coptidis, Salvia miltiorrhiza, and pueraria lobata. Ganoderma lucidum. It is commonly used in commonly used drugs, heat clearing drugs, antipyretic drugs, and astringent drugs as the most common categories. The composition of the drug is the highest level (31.03%), the highest in the drug taste is sweetness (79.31%), and the highest ratio of the drug to the meridian is the clear clinical significance of the lung meridian (48.28%).29 flavors in accordance with the drug property. To sum up the core prescription of Professor chestnut in the treatment of DM by Professor Li Qi Huang Xiaoke soup, the use of drugs mostly flat cold, bitter taste, pay attention to the use of supplementation and clear method, think that Qi Yin deficiency and dryness heat blood stasis is the main syndrome type of DM, with nourishing Qi Nourishing Yin Clearing Heat and promoting blood circulation and removing blood stasis as treatment Dafa. The first part of the clinical study of urinary nephrotic disease (stage III to IV): the first part of the literature review (2): the progress in the modern medical research of first diabetic kidney diseases, review the pathogenesis, early diagnosis and Western medicine treatment of diabetic kidney disease in the last ten years. The research progress of second Chinese medicine in the treatment of diabetic kidney disease is reviewed. Ten years of diabetes kidney disease of Chinese medicine name, pathogenesis, pathogenesis, syndrome differentiation, problems and prospects of research. The second part of clinical study: three a kidney elimination soup treatment of Qi Yin deficiency and stagnation of kidney disease (stage III to IV) clinical study of kidney disease (stage III to IV): observation of three a kidney elimination Decoction for the treatment of Qi Yin deficiency and stagnation of internal resistance diabetes kidney The clinical efficacy and safety of the disease (stage III to IV). Study methods: 80 patients were divided into the control group, the treatment group, the control group, the control group, the base therapy gallulin new treatment. The treatment group was treated with the basic treatment and the three nail kidney elimination decoction. The treatment group and the control group were divided into 8 weeks. The symptoms and signs of the two groups of Chinese medicine were accumulated before and after the treatment. 24 hours urine protein quantitative, renal function index, blood sugar, glycated hemoglobin, blood lipid, blood rheology and safety indexes. The results were as follows: 1, the total effective rate of the control group was 70%, the total effective rate of the treatment group was 85%, and the two groups were statistically significant (P < 0.05); 2, the treatment group was reduced (P0.05) after treatment (P0.05), and the control group. After treatment, only TG decreased (P < 0.05), and the difference of TG in two groups was statistically significant (P0.05); 3, after treatment, the whole blood in the treatment group was relatively low cut and relatively sticky.
【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R249;R259

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