摘要
目的:观察在西药基础上中医辨证施治对糖尿病肾病代偿期患者近期及远期的临床疗效。方法:符合中西医诊断标准的134例糖尿病肾病肾功能不全代偿期患者随机分为观察和对照两组,各67例。对照组采用健康教育、控制饮食、常规西医西药降糖降压等治疗措施,观察组在对照组基础上以中药辨证治疗,对阴虚型、阳虚型及阴阳两虚型分别予止消通脉宁、止消温肾宁及止消保肾宁颗粒。观察两组治疗前及治疗3个月后的临床疗效、中医症状积分、肾功能及24个月后的病情进展状况。结果:治疗3个月,观察组治疗总有效率(83.6%)与对照组(79.1%)无显著性差异,但观察组中医证候积分(19.3±2.8)及血肌酐浓度(131.7±30.5)μmol/L均低于对照组(26.9±4.0)、(143.6±34.2)μmol/L且差异有统计学意义。随访2年,观察组4例(6.2%)发生DN进展,显著低于对照组11例(17.2%),两组比较差异有统计学意义。结论:建立在西医基础上的中医辨证治疗方案虽不能明显提高代偿期DN患者近期的总体疗效,但可一定程度上改善其肾功能及中医证候,并有效延缓远期的病情进展。
Objective ： To investigate the short term and long term clinical effect of TCM syndrome differentiation in patients with diabetic nephropathy （DN） in compensatory phase. Methods： The selected 134 cases with DN in compensatory phase were randomly divided into 2 groups, 67 of each. Patients in the control group were applied with western medicine alone while the observing group was treated with Chinese medicine granules according with syndrome based on the control. Then short term was lasted 3 months and long term means following up for 2 years. Total effective rate, syndrome score and renal function indexes during short term and progression of DN during long term of the two groups were both detected. Results ： After 3 months treatment, although the total effective rate had no significant differences between the two groups, the observed group was superior to the control group in terms of syndrome score [ （ 19.3 ± 2.8） vs （ 26.9 ± 4.0） ] and serum creatinine [ （ 131.7 ±30.5） vs （ 143.6 ±34.2） ] umol/L. When following up for 2 years, there were 4 cases（6.2% ） progression of DN in observing group, compared with 7 cases （ 17.2% ） in the control, the difference was statistical significant. Conclusions： The therapy of TCM syndrome differentiation based on the modern medicine, although could not improve the total effective rate of patients with renal insufficiency due to DN, can promote the renal function indexes and syndromes to some extent, and also can postpone the proceeding from compensatory to decompensatory.
出处
《中华中医药学刊》
CAS
2013年第6期1431-1433,共3页
Chinese Archives of Traditional Chinese Medicine
