糖肾康饮治疗早期糖尿病肾病的临床疗效观察及对TNF-α的影响

发布时间：2018-03-18 15:02

本文选题：糖肾康饮　切入点：早期糖尿病肾病　出处：《黑龙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察自拟方糖肾康饮治疗早期糖尿病肾病(DN)气阴两虚夹瘀型患者的临床疗效及对患者血清TNF-α水平的影响。方法：选取符合本临床研究纳入标准的早期DN患者80例,随机分为两组,对照组和治疗组,每组各40例。其中对照组给予基础治疗：糖尿病(DM)教育、饮食控制、运动疗法、调节血糖、调节血脂等；治疗组在基础治疗的同时加服自拟方糖肾康饮,两组疗程均为8周。疗程结束后,分析两组患者的尿微量白蛋白排泄率(UAER)、血清T NF-α、中医证候积分及单项症状积分等相关指标治疗前后的变化,比较两组的总有效率。结果：1.疗程结束后,比较两组的总有效率：治疗组为73.7%,对照组为25.0%,两组比较有显著统计学意义(P0.01)；提示在临床疗效上,治疗组明显优于对照组。2.疗程结束后,治疗组中医证候总积分及单项积分较治疗前均明显下降(P0.01),与对照组比较(P0.01)；且治疗组的总有效率为78.9%,对照组的为20.0%,两组比较统计学意义显著(P0.01)；说明糖肾康饮对早期DN患者中医证候及单项症状积分的改善明显优于对照组。3.治疗组患者治疗后UAER较治疗前明显下降(P0.01),对照组与疗前无明显变化(P0.05)；两组比较有显著统计学意义(P0.01)；说明糖肾康饮能明显降低UAER,且优于对照组。。4.治疗8周后,对照组患者血清TNF-α未见明显改变甚有轻微升高；治疗组患者血清TNF-α较治疗前明显下降(P0.01),与对照组比较(P0.01)。提示糖肾康饮能够降低DN患者血清T NF-α水平,且优于对照组。结论：1.糖肾康饮可以降低气阴两虚夹瘀早期DN患者的中医证候积分,改善患者中医临床症状；2.糖肾康饮可以降低早期DN患者UAER,减轻肾脏受损程度；3.糖肾康饮可能是通过降低患者血清TNF-α的水平,起到延缓DN进展的作用。
[Abstract]:Objective: to observe the clinical curative effect and influence on serum TNF- 伪 level of patients with early diabetic nephropathy (DNs) with deficiency of qi and yin and blood stasis. Methods: 80 cases of early DN patients who met the criteria included in this clinical study were selected. The control group was divided into two groups randomly, the control group and the treatment group with 40 cases in each group. The control group was given basic treatment: diabetes mellitus (DM) education, diet control, exercise therapy, regulation of blood sugar, regulation of blood lipid, etc. The treatment group was treated with Tangshenkang decoction at the same time as basic treatment. The course of treatment in both groups was 8 weeks. The changes of urinary microalbumin excretion rate (UAERA), serum TNF- 伪, TCM syndromes score and single symptom score before and after treatment were analyzed, and the total effective rates of the two groups were compared. The total effective rate was 73.7in the treatment group and 25.0 in the control group. There was significant statistical significance between the two groups, suggesting that the treatment group was better than the control group in clinical efficacy. The total integral and single score of TCM syndromes in the treatment group were significantly lower than those before treatment, and the total effective rate was 78.9 in the treatment group and 20.0 in the control group, indicating that Tangshenkang decoction was effective in the early stage of the treatment group, and the total effective rate was 78.9 in the treatment group and 20.0 in the control group, and the difference between the two groups was statistically significant (P 0.01), which indicated that Tangshenkang decoction was effective in the early stage. The improvement of TCM syndromes and single symptom scores in DN patients was significantly better than that in control group .3.After treatment, the UAER of patients in the treatment group was significantly lower than that before treatment, but there was no significant change in the control group and before treatment. Tangshenkang decoction can significantly reduce UAER, and is superior to control group ..4.After 8 weeks of treatment, The serum TNF- 伪 level of the patients in the treatment group was significantly lower than that of the patients before treatment, and that of the control group was significantly lower than that of the control group. It suggested that Tangshenkang decoction could reduce the level of TNF- 伪 in the serum of DN patients, and the level of TNF- 伪 in the patients with DN was significantly lower than that in the control group. Conclusion 1. Tangshenkang decoction can reduce the syndromes integral of DN patients with Qi and Yin deficiency and blood stasis in the early stage. 2. Tangshenkang decoction can reduce UAERand reduce the degree of kidney damage in early DN patients. Tangshenkang decoction may delay the progression of DN by lowering the level of TNF- 伪 in serum.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.2;R692.9

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