152例糖尿病肾病的证候及疗效分析

152 Patienss with Symptoms of Diabetic Nephropathy and Clinical Analysis

目的:总结糖尿病肾病(DN)的诊治方法及总体疗效。方法:通过回顾我科近5年152例住院及门诊DN患者的诊治过程,归纳其证型分布和治疗方案特点,研究治疗方案的有效性及不足之处。结果:(1)DN患者UAER组以气阴两虚证为主,临床蛋白尿期以脾肾气/阳虚证为主,而ESRD组而证型较为分散,而血瘀证分布于各型各期且最多,约占60.51%.(2)经采用西医规范治疗,配合中医辨证论治及活血化瘀中成药治疗1月时,HBAlc、CRP、TG及部分sCr、cCr均得到改善;治疗2月时mALB、Alb明显下降。结论:(1)血瘀证是DN疾病中最常见的证型。(2)短期治疗可以改善症状,并整体改善患者病情。(3)尿mAL、BAlb在治疗2月时明显下降。

Objective：To summarize the diagnosis,treatment and overall efficacy of diabetic nephropathy（DN）.Methods：Through a review of 152 cases on DN diagnosis and treatment of outpatients or inpatients of the past 5 years,summarized pattern distribution and the characteristics of their teatment,study the treatment＇s effectiveness and deficiency.Results：（1）Qi and Yin deficiency pattern is main in UAER group,spleen and kidney Qi/Yang Deficiency-based pattern is main in clinical proteinuria group,and the patterns are dispersed in ESRD group,however,blood stasis distributed in all kinds of types and groups,it is 60.51 percent of the total number of DN patients.（2）Hemoglobin（HBAIC）,C-reactive protein（CRP）,triglyceride（TG）,and some renal function（sCr,cCr）were improved a month later,glycosylated urinary albumin（mALB）and 24 hour urinary protein（ALb）decreased obviously after two months by the treatment with Western medicine,traditional Chinese medicine,and Chinese patent medicine.Conclusion：（1）Blood Stasis is the most common pattern of DN.（2）Short-term treatment can improve symptoms and the overall Status.（3）mALB,Alb can be significantly reduced after 2-month treatment.