中医辨证分型治疗Ⅳ期糖尿病肾病疗效观察.docVIP

中医辨证分型治疗Ⅳ期糖尿病肾病的疗效观察 　　[摘要] 目的 探讨辨证分型治疗Ⅳ期糖尿病肾病疗效。 方法 将2型糖尿病合并Ⅳ期糖尿病肾病的70例患者随机分为治疗组36例和对照组34例。对照组按《中国2型糖尿病防治指南（2010年版）》进行降糖、降压、调脂、抗血小板等常规治疗；治疗组分气阴两虚、肝肾阴虚、气血两虚、脾肾阳虚四型进行辨证施治。观察两组治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白、尿微量白蛋白排泄率、24 h尿蛋白定量、肌酐、尿素氮、血清总胆固醇、甘油三酯等指标变化情况，并评估两组治疗有效率。 结果 治疗后，治疗组糖代谢情况、尿蛋白排泄、肾功能等相关指标均较对照组有明显改善（P0.05）；治疗组总有效率83.33%，明显高于对照组总有效率61.76%，差异有显著性（P0.05）。 结论 采用辨证分型治疗Ⅳ期糖尿病肾病，疗效明显。 　　[关键词] 糖尿病肾病；消渴肾病；辨证分型；中医药治疗 　　[中图分类号] R259 [文献标识码] B [文章编号] 1673-9701（2016）35-0124-03 　　Observation on curative effect of TCM syndrome differentiation on stage Ⅳ diabetic nephropathy 　　ZHU Yingling WANG Yi 　　Department of Traditional Chinese Medicine， Yancheng Third Peoples Hospital in Jiangsu Province，Yancheng 224000，China 　　[Abstract] Objective To explore the effect of syndrome differentiation on the treatment of stage Ⅳ diabetic nephropathy. Methods 70 patients with type 2 diabetes mellitus and stage Ⅳ diabetic nephropathy were randomly divided into treatment group （36 cases） and control group （34 cases）. The control group according to Chinese type 2 diabetes prevention and control guidelines （2010 edition） was given conventional treatment including lowering blood sugar， antihypertensive， lipid-lowering， anti-platelet and so on. The treatment group was given dialectical treatment according to four types such as qi and yin deficiency， liver and kidney， qi and blood deficiency， spleen and kidney yang deficiency.The changes of fasting blood glucose， 2-hour postprandial blood glucose， glycosylated hemoglobin， urinary albumin excretion rate， 24 h urinary protein quantity，creatinine，urea nitrogen， serum total cholesterol and triglycerides were observed before and after treatment. Results After treatment，the indexes of glycometabolism， urinary protein excretion， renal function in the treatment group were significantly improved（P0.05） compared with the control group.The total effective rate of the treatment group was 83.33%， which was significantly higher than that of the control group（61.76%