中西医结合治疗糖尿病肾病49例临床疗效观察

Clinical Efficacy Observation of 49 Cases of Diabetic Nephropathy Treated with Integrated Chinese and Western Medicine

目的观察中西医结合治疗糖尿病肾病的临床疗效。方法 98例患者随机分为两组,每组49例。两组患者均给予糖尿病教育,给予合理控制饮食,采用低盐、低脂、优质低蛋白饮食,适当运动;口服降糖药或注射胰岛素控制血糖,合并高血压者配合降压药物治疗,合并高脂血症者给予他汀类药物降脂治疗。治疗组在上述治疗的基础上采用七味白术散加减治疗。1个月为1个疗程,2个疗程后统计疗效。两组患者分别在用药前、用药后检测空腹血糖、血清胆固醇、甘油三酯、血浆白蛋白、24 h尿蛋白定量、血肌酐、尿素氮。结果两组患者治疗后总有效率治疗组为81.63%,对照组为61.22%,差异有统计学意义(P<0.05),治疗组疗效优于对照组。两组患者治疗前后比较差异有统计学意义(P<0.05),治疗组治疗后各项指标较对照组明显改善,差异有统计学意义(P<0.05)。结论中西医结合治疗糖尿病肾病可以明显改善糖尿病肾病患者空腹血糖、血清胆固醇、甘油三酯等,该疗法弥补了西药的不足。

Objective To observe the clinical efficacy of diabetic nephropathy（DN） treated with in tegrated Chinese and western medicine. Methods 98 cases were randomized into two groups, 49 cases in each one. The patients in either group received the education on diabetics, controlled diet reasonably, accepted low - salt, low - fat, high quality but low protein diet and had appropriate physical exercises. Additionally, the patients took anti - glucose drug or injected insulin for blood glucose control. For those complicated with hypertension ,the antihypertensive drug was supplemented. For those complicated with hyperlipemia, the statins was given to reduce lipid. In the treatment group, on the basis of the therapeutic program as the above, the modified qiwei baizhu san was supplemented. The treatment of 1 month was taken as 1 session. The efficacy was analyzed in statistics after 2 session treatments. Separately, before and after medication, fasting glucose （ GLU ）, serum cholesterol （ CHOL）, triglyceride （ TG ）, plasma albumin （ ALB ）, 24h urine protein quantification（24 h PRO） , blood creatinine （CR）and urea nitrogen（BUN） were detected. Results The total effective rate was 81.63 % in the treatment group and was 61.22% in the control group after treatment,indicating the statistical significant difference in comparison（ P 〈0.05 ）. After treatment, every index was improved apparently in the treatment group as compared with that in the control group, presenting the statistical significant difference （ P 〈 0.05 ）. Conclusion The integrated Chinese and western medicine can improve obviously the levels of GLU, CHOL, TG and the other indexes for the patients with DN. This therapy makes up the shortages of western medicine.