参芪地黄汤加减改善2型糖尿病患者早期肾病（气阴两虚型）临床疗效观察

发布时间：2018-02-08 19:58

本文关键词： 参芪地黄汤加减早期糖尿病肾病气阴两虚临床研究　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：糖尿病肾病(DKD)是导致慢性肾衰竭的重要原因之一,为延缓糖尿病肾病的发病进展,降低糖尿病终末期肾病对患者的危害,拟初步观察中药汤剂参芪地黄汤加减降低气阴两虚型2型糖尿病患者早期肾病微量蛋白尿的疗效及改善临床症状的效果,以期为治疗早期糖尿病肾病寻找最佳治疗方案。方法：采用随机对照的研究方法,选取成都中医药大学附属医院2015年1月至2015年11月期间内分泌科住院病人中明确诊断为2型糖尿病早期肾病且辨证属气阴两虚型者52例,随机分为对照组及治疗组两组。对照组行常规基础治疗,包括控制血糖、血脂及原发病的治疗,治疗组在常规基础治疗基础上,辨证使用中药汤剂参芪地黄汤加减。两组均以12周为一个治疗周期,观察并比较两组在治疗前后尿微量白蛋白与肌酐比值(ACR)、尿微白蛋白(mALB)、α 1-微球蛋白(α1-MG)及临床症状的变化,同时监测生命体征及血、尿、便常规、肝肾功、心电图等相关安全性指标。同组治疗前后比较采用配对t检验,组间比较采用独立样本t检验或独立样本非参数检验。检验水准α=0.05,P0.05为差异有统计学意义,P0.05差异无统计学意义。结果：1.治疗组与对照组两组组间比较,治疗组ACR、mALB、α1-MG水平下降明显(P0.05),组间差异有统计学差意义(P0.05)；2.治疗组加用参芪地黄汤加减治疗早期糖尿肾病后,患者ACR、mALB、α1-MG及临床症状较治疗前均有明显改善(P0.05),有统计学意义,对照组差异无统计学意义；3.使用参芪地黄汤后,患者血常规、尿常规、便常规、肝肾功、心电图等安全性指标未见明显异常,证明使用参芪地黄汤加减治疗早期糖尿病肾病安全性良好。结论：1.参芪地黄汤加减可降低早期糖尿病肾病尿微量蛋白,延缓糖尿病肾病的进展,且安全性良好；2.参芪地黄汤加减可改善气阴两虚型2型糖尿病患者早期肾病的临床症状,提高患者生活质量。
[Abstract]:Objective: diabetic nephropathy (DKD) is one of the important causes of chronic renal failure (CRF). To observe the effect of Shenqi Dihuang decoction on reducing microalbuminuria and improving clinical symptoms in patients with type 2 diabetes mellitus with deficiency of Qi and Yin. Methods: a randomized controlled study was used to find the best treatment for early diabetic nephropathy. From January 2015 to November 2015 in the affiliated Hospital of Chengdu University of traditional Chinese Medicine, 52 cases of early nephropathy of type 2 diabetes mellitus with syndrome differentiation of deficiency of Qi and Yin were selected. They were randomly divided into two groups: the control group and the treatment group. The control group was treated with routine basic treatment, including the control of blood glucose, blood lipid and primary disease, and the treatment group was based on the routine basic treatment. Two groups were treated with 12 weeks as a treatment cycle. The changes of the ratio of urinary microalbumin to creatinine in two groups before and after treatment were observed and compared. The changes of urinary microalbuminuria mALBX, 伪 1-microglobulin (伪 1-MGG) and clinical symptoms were observed and compared before and after treatment. Vital signs, blood, urine, stool routine, liver and kidney function, electrocardiogram and other related safety indexes were monitored. T test of independent sample or non-parametric test of independent sample were used in the comparison between the two groups. There was no significant difference in the test level between the two groups. There was no significant difference between the two groups (P0.05). The results showed that there was no significant difference between the treatment group and the control group, and there was no significant difference between the treatment group and the control group. In the treatment group, the levels of ACR-mALB, 伪 1-MG decreased significantly (P 0.05), and there was a significant difference between the two groups. After the treatment group was treated with Shenqi Dihuang decoction, the patients' ACR-mALB, 伪 1-MG and clinical symptoms were significantly improved compared with those before treatment (P 0.05N, P 0.05). After using Shenqi Dihuang decoction, the patients' blood routine, urine routine, stool routine, liver and kidney function, electrocardiogram and other safety indexes were not significantly abnormal. It is proved that Shenqi Dihuang decoction is safe in the treatment of early diabetic nephropathy. Conclusion 1. Shenqi Dihuang decoction can reduce urinary trace protein of early diabetic nephropathy and delay the progress of diabetic nephropathy. Shenqi Dihuang decoction can improve the clinical symptoms of early nephropathy and improve the quality of life of patients with type 2 diabetes mellitus with deficiency of Qi and Yin.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.5

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