益气养阴清利祛风化瘀法治疗糖尿病肾病Ⅳ期的临床观察

发布时间：2018-01-03 06:39

本文关键词：益气养阴清利祛风化瘀法治疗糖尿病肾病Ⅳ期的临床观察　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察和验证老师在临床实践中总结的益气养阴清利祛风化瘀法治疗糖尿病肾病(Diabetic nephropathy, DN) IV期的临床疗效。方法：查阅有关文献,收集、挖掘有关DN的中西医病因病机,整理其主要治则治法及临床已获得的成效,在此基础上,总结和分析益气养阴清利祛风化瘀法治疗DNIV期患者证属气阴两虚湿瘀证的理法方药之间的特点,并对其疗效进行观察。临床观察病例选择符合条件的江苏省中医院肾内科门诊及住院病人60例,随机分为治疗组和对照组,对照组给予西医常规治疗,治疗组在此基础上加用益气养阴清利祛风化瘀方：生黄芪30g,淮山药10g,山萸肉15g,生地黄12g,京玄参10g,天花粉20g,玉米须15g,细石韦30g,青风藤30g,晚蚕沙20g,鬼箭羽20g,紫丹参15g。可视病情随症加减。每日1剂,水煎两遍,取汁400m1,分早晚2次温服。疗程为12周。观察治疗前后中医症状积分、U-TP、FPG、Scr, BUN、UA、Alb、Hb、ALT、AST的变化情况,并进行统计学分析。结果：治疗组总有效率为83.3%,中医证候改善总有效率为86.7%；对照组总有效率为70%,中医证候改善总有效率为73.4%。组内比较：两组U-TP、FPG、Scr、BUN经过治疗后均有下降(P0.01)；治疗组UA治疗后改善明显(P0.01),在对照组治疗后无明显改善；两组Hb、Alb、ALT、AST治疗后均无明显变化。组间比较：在改善U-TP、FPG、Scr,BUN方而,治疗组明显优于对照组(P0.05), UA、Alb、Hb、ALT、AST经过治疗后两组比较均无统计学差异。结论：益气养阴清利祛风化瘀法对DNIV期属气阴两虚湿瘀证的患者具有较好的疗效,在改善临床症状和降低尿蛋白、控制血糖、稳定肾功能方而有较好的效果,值得进一步深入研究。
[Abstract]:Objective: to observe and verify the method of nourishing qi, nourishing yin, clearing away wind and removing wind and removing blood stasis, which was summed up by teacher in clinical practice in treating diabetic nephropathy with diabetic nephropathy. Methods: to review relevant literature, collect and excavate the etiology and pathogenesis of traditional Chinese and western medicine about DN, and sort out the main treatment principles and clinical results. Summary and analysis of Qi-nourishing Yin Qingli dispelling wind and removing blood stasis treatment of DNIV patients with syndrome of Qi and Yin deficiency of dampness and stasis between the characteristics between the prescription. The clinical observation cases were divided into two groups randomly: treatment group and control group, and the control group was given routine western medicine treatment. The clinical observation cases were selected from the outpatient and inpatient department of Department of Nephrology, Jiangsu traditional Chinese Medicine Hospital, and were randomly divided into treatment group and control group. On this basis, the treatment group was treated with Qi nourishing Yin, clearing away wind and removing wind and removing blood stasis prescription: ShengHuangqi 30g, Huai yam 10g, Cornel 15g, Rehmannia 12g, Beijing Xuanshen 10g, Trichosanthus 20g. Corn must 15 g, fine stone Wei 30 g, green wind rattan 30 g, late silkworm sand 20 g, ghost arrow 20 g, purple salvia miltiorrhiza 15 g. The course of treatment was 12 weeks. Before and after treatment, the changes of TCM symptom scores were observed. Results: the total effective rate of treatment group was 83.3, the total effective rate of TCM syndrome improvement was 86.7; The total effective rate of the control group was 70 and the total effective rate of improving TCM syndrome was 73.4. In the treatment group, UA was significantly improved after treatment, but not in the control group. There were no significant changes in the two groups after treatment. Comparison between the two groups: in the improvement of U-TPG FPG Scr-bun prescription. The treatment group was superior to the control group (P 0.05). There was no statistical difference between the two groups after AST treatment. Conclusion: the method of supplementing qi, nourishing yin, clearing away wind and removing wind and removing blood stasis has better curative effect on patients with Qi and Yin deficiency and dampness stasis syndrome in DNIV stage. It has good effect in improving clinical symptoms, lowering urine protein, controlling blood sugar and stabilizing renal function.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.5

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